Provider Demographics
NPI:1598338980
Name:AUGUSTA RHEUMATOLOGY INSTITUTE, LLC
Entity Type:Organization
Organization Name:AUGUSTA RHEUMATOLOGY INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NAVEEDA
Authorized Official - Middle Name:TABASSUM
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-305-9500
Mailing Address - Street 1:4247 COLONY SQ
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4286
Mailing Address - Country:US
Mailing Address - Phone:706-799-3445
Mailing Address - Fax:
Practice Address - Street 1:1109 MEDICAL CENTER DR STE 2B
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-6675
Practice Address - Country:US
Practice Address - Phone:706-977-5869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty