Provider Demographics
NPI:1649424599
Name:ATLANTA CARDIO-PULMONARY RESEARCH CLINIC
Entity Type:Organization
Organization Name:ATLANTA CARDIO-PULMONARY RESEARCH CLINIC
Other - Org Name:ACPRC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:SULLIVAN
Authorized Official - Last Name:MASLANKA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MA, ABD
Authorized Official - Phone:404-966-3775
Mailing Address - Street 1:7300 CHATTAHOOCHEE BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-1072
Mailing Address - Country:US
Mailing Address - Phone:404-966-3775
Mailing Address - Fax:
Practice Address - Street 1:1100 JOHNSON FERRY RD NE BLDG II
Practice Address - Street 2:SUITE 165
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1709
Practice Address - Country:US
Practice Address - Phone:404-966-3775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center