Provider Demographics
NPI:1629344841
Name:DEMBOSKI HEALTHCARE INC
Entity Type:Organization
Organization Name:DEMBOSKI HEALTHCARE INC
Other - Org Name:NORTH GEORGIA PAIN MANAGEMENT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DEMBOSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:770-888-8292
Mailing Address - Street 1:6030 BETHELVIEW RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-8020
Mailing Address - Country:US
Mailing Address - Phone:770-888-8292
Mailing Address - Fax:770-888-9858
Practice Address - Street 1:6030 BETHELVIEW RD
Practice Address - Street 2:SUITE 502
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8020
Practice Address - Country:US
Practice Address - Phone:770-888-8292
Practice Address - Fax:770-888-9858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty