Provider Demographics
NPI:1346267010
Name:ALBANY GASTROENTEROLOGY, PC
Entity Type:Organization
Organization Name:ALBANY GASTROENTEROLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:DREMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-883-0298
Mailing Address - Street 1:1009 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1970
Mailing Address - Country:US
Mailing Address - Phone:229-883-0298
Mailing Address - Fax:229-438-7898
Practice Address - Street 1:1009 N MONROE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1970
Practice Address - Country:US
Practice Address - Phone:229-883-0298
Practice Address - Fax:229-438-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3106Medicare ID - Type Unspecified