Provider Demographics
NPI:1568412294
Name:CYRUS EMERGENCY PHYSICIANS, LLC
Entity Type:Organization
Organization Name:CYRUS EMERGENCY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'MEARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-481-7483
Mailing Address - Street 1:PO BOX 933049
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-3049
Mailing Address - Country:US
Mailing Address - Phone:866-313-5266
Mailing Address - Fax:205-313-5245
Practice Address - Street 1:2260 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-4764
Practice Address - Country:US
Practice Address - Phone:866-313-5266
Practice Address - Fax:205-313-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADC5996OtherRR MCARE GRP#
SCGPA885Medicaid
SCGPA885Medicaid
GADC5996OtherRR MCARE GRP#