Provider Demographics
NPI:1528550670
Name:NEW HEART MEDICAL LLC
Entity Type:Organization
Organization Name:NEW HEART MEDICAL LLC
Other - Org Name:NEW HEART MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMU
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRUILL-BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:770-648-6804
Mailing Address - Street 1:1021 ROSSER ST NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4463
Mailing Address - Country:US
Mailing Address - Phone:770-648-6804
Mailing Address - Fax:770-648-6789
Practice Address - Street 1:1021 ROSSER ST NW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-4463
Practice Address - Country:US
Practice Address - Phone:404-840-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty