Provider Demographics
NPI:1093487746
Name:BABYLON HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:BABYLON HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEGAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:800-475-6168
Mailing Address - Street 1:PO BOX 1543
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78767-1543
Mailing Address - Country:US
Mailing Address - Phone:800-475-6168
Mailing Address - Fax:
Practice Address - Street 1:1450 W PEACHTREE ST. NW #200
Practice Address - Street 2:PMB 53059
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2955
Practice Address - Country:US
Practice Address - Phone:800-475-6168
Practice Address - Fax:855-943-1026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0225357Medicaid
IN300051835Medicaid
IA1225357Medicaid
IA2225357Medicaid
NV250008725Medicaid
IA3225357Medicaid