Provider Demographics
NPI:1609021260
Name:ATHENS REGIONAL HEALTH CENTER LLC
Entity Type:Organization
Organization Name:ATHENS REGIONAL HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-847-5971
Mailing Address - Street 1:5174 MCGINNIS FERRY RD
Mailing Address - Street 2:#146
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1792
Mailing Address - Country:US
Mailing Address - Phone:888-847-5971
Mailing Address - Fax:
Practice Address - Street 1:1010 PRINCE AVE
Practice Address - Street 2:#184N
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5805
Practice Address - Country:US
Practice Address - Phone:888-847-5971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007566208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty