Provider Demographics
NPI:1386180206
Name:ASSURE MEDICAL EXAMS, LLC
Entity Type:Organization
Organization Name:ASSURE MEDICAL EXAMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:CONCHETTA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:706-641-2151
Mailing Address - Street 1:1711 BUENA VISTA RD
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-6141
Mailing Address - Country:US
Mailing Address - Phone:706-641-2151
Mailing Address - Fax:706-641-2171
Practice Address - Street 1:1711 BUENA VISTA RD
Practice Address - Street 2:SUITE # 2
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-6141
Practice Address - Country:US
Practice Address - Phone:706-641-2151
Practice Address - Fax:706-641-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN212280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty