GEORGIA SOUTH HAND THERAPY, INC

Provider Demographics

• NPI: 1609963115
• Name: GEORGIA SOUTH HAND THERAPY, INC
• Entity Type: Organization
• Organization Name: GEORGIA SOUTH HAND THERAPY, INC
• Authorized Official - Title/Position: OFFICE/BILLING MANAGER
• Authorized Official - Prefix: MS
• Authorized Official - First Name: LUCY
• Authorized Official - Last Name: THOMAS
• Authorized Official - Phone: 770-474-4595
• Mailing Address - Street 1: 7444 HANNOVER PKWY S
• Mailing Address - Street 2: SUITE 250
• Mailing Address - City: STOCKBRIDGE
• Mailing Address - State: GA
• Mailing Address - Zip Code: 30281-9303
• Mailing Address - Country: US
• Mailing Address - Phone: 770-474-4595
• Mailing Address - Fax: 770-474-4182
• Practice Address - Street 1: 7444 HANNOVER PKWY S
• Practice Address - Street 2: SUITE 250
• Practice Address - City: STOCKBRIDGE
• Practice Address - State: GA
• Practice Address - Zip Code: 30281-9303
• Practice Address - Country: US
• Practice Address - Phone: 770-474-4595
• Practice Address - Fax: 770-474-4182
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-10-06
• Last Update Date: 2009-10-01

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	332BC3200X	Suppliers	Durable Medical Equipment & Medical Supplies	Customized Equipment
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	225XH1200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Hand	Group - Multi-Specialty
No	335E00000X	Suppliers	Prosthetic/Orthotic Supplier

Provider Identifiers

State	Identifier ID	ID Type	Issuer
GA	#P-11215765	Other	MULTI PLAN HEALTH
GA	670002188	Other	RAILROAD MEDICARE
GA	253024492A	Medicaid
GA	612611600	Other	DEPT OF LABOR
GA	7921605	Other	AETNA HEALTH INS
GA	612611600	Other	DEPT OF LABOR
GA	#P-11215765	Other	MULTI PLAN HEALTH
GA	552750001	Medicare PIN