Provider Demographics
NPI:1871031625
Name:GWINNNETT HOSPITAL SYSTEM, INC.
Entity Type:Organization
Organization Name:GWINNNETT HOSPITAL SYSTEM, INC.
Other - Org Name:GWINNETT MEDICAL CENTER ASSOCIATE HEALTH AND WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:E
Authorized Official - Last Name:OREM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-312-5633
Mailing Address - Street 1:PO BOX 1190
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-1190
Mailing Address - Country:US
Mailing Address - Phone:678-312-0470
Mailing Address - Fax:
Practice Address - Street 1:665 DULUTH HWY
Practice Address - Street 2:SUITE 501
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8709
Practice Address - Country:US
Practice Address - Phone:678-312-0470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GWINNETT HOSPITAL SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-01
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty