Provider Demographics
NPI:1275852949
Name:HYOX MEDICAL TREATMENT CENTER
Entity Type:Organization
Organization Name:HYOX MEDICAL TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-303-3200
Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:678-303-3200
Mailing Address - Fax:678-303-3205
Practice Address - Street 1:500 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8708
Practice Address - Country:US
Practice Address - Phone:678-303-3200
Practice Address - Fax:678-303-3205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HYOX MEDICAL TREATMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA114535Medicare PIN