Provider Demographics
NPI:1376864538
Name:COMMUNITY HEALTH NETWORK OF NORTHEAST GEORGIA
Entity Type:Organization
Organization Name:COMMUNITY HEALTH NETWORK OF NORTHEAST GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-334-2493
Mailing Address - Street 1:1 N TENNESSEE ST
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3339
Mailing Address - Country:US
Mailing Address - Phone:770-334-2485
Mailing Address - Fax:
Practice Address - Street 1:1 N TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3339
Practice Address - Country:US
Practice Address - Phone:770-334-2485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care