Provider Demographics
NPI:1821361577
Name:SENIOR CARE OFFICE, LLC
Entity Type:Organization
Organization Name:SENIOR CARE OFFICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SWATI
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-219-8600
Mailing Address - Street 1:601 S. ENOTA DRIVE
Mailing Address - Street 2:SUITE Q
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2240
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:770-219-8440
Practice Address - Street 1:2020 BEVERLY ROAD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2037
Practice Address - Country:US
Practice Address - Phone:770-219-8600
Practice Address - Fax:770-219-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-10
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057624207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty