Provider Demographics
NPI:1346579935
Name:MERIWETHER HEALTHCARE, L.L.C.
Entity Type:Organization
Organization Name:MERIWETHER HEALTHCARE, L.L.C.
Other - Org Name:SOUTHERN CRESCENT SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-502-2150
Mailing Address - Street 1:1755 HIGHWAY 34 E
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-5631
Mailing Address - Country:US
Mailing Address - Phone:770-502-2150
Mailing Address - Fax:770-502-2190
Practice Address - Street 1:1755 HIGHWAY 34 E
Practice Address - Street 2:SUITE 2400
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-5631
Practice Address - Country:US
Practice Address - Phone:770-502-2150
Practice Address - Fax:770-502-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty