Provider Demographics
NPI:1467625137
Name:NCR ENTERPRISE, INC
Entity Type:Organization
Organization Name:NCR ENTERPRISE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:PALERINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-257-9998
Mailing Address - Street 1:106 ENTERPRISE CT STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-9096
Mailing Address - Country:US
Mailing Address - Phone:706-257-9998
Mailing Address - Fax:706-257-9993
Practice Address - Street 1:106 ENTERPRISE CT STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9096
Practice Address - Country:US
Practice Address - Phone:706-257-9998
Practice Address - Fax:706-257-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty