Provider Demographics
NPI:1164883492
Name:NAVICENT HEALTH
Entity Type:Organization
Organization Name:NAVICENT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ER PHYSICIAN ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:RASHAD
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:678-662-9411
Mailing Address - Street 1:3165 KINGS ARMS CT NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2152
Mailing Address - Country:US
Mailing Address - Phone:678-662-9411
Mailing Address - Fax:
Practice Address - Street 1:777 HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2102
Practice Address - Country:US
Practice Address - Phone:478-633-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital