Provider Demographics
NPI:1457329989
Name:THE CHILDRENS CENTER FOR DIGESTIVE HEALTH CARE LLC
Entity Type:Organization
Organization Name:THE CHILDRENS CENTER FOR DIGESTIVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT FOR CCDHC
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SARIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-257-0799
Mailing Address - Street 1:993D JOHNSON FERRY ROAD
Mailing Address - Street 2:STE 440
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-257-0799
Mailing Address - Fax:404-503-2280
Practice Address - Street 1:993D JOHNSON FERRY ROAD
Practice Address - Street 2:STE 440
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-257-0799
Practice Address - Fax:404-503-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty