Provider Demographics
NPI:1306357470
Name:AMERICAN CARDIOVASCULAR CENTERS, P.C.
Entity Type:Organization
Organization Name:AMERICAN CARDIOVASCULAR CENTERS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-416-6438
Mailing Address - Street 1:6105 PEACHTREE DUNWOODY RD STE A150
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5944
Mailing Address - Country:US
Mailing Address - Phone:404-996-6596
Mailing Address - Fax:
Practice Address - Street 1:6105 PEACHTREE DUNWOODY RD STE A150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:404-996-6596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN CARDIOVASCULAR CENTERS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-17
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies