Provider Demographics
NPI:1922258946
Name:MEMORIAL HEALTH PARTNERS FOUNDATION
Entity Type:Organization
Organization Name:MEMORIAL HEALTH PARTNERS FOUNDATION
Other - Org Name:TCFPA FAMILY MEDICAL CENTERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:REGISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-495-6870
Mailing Address - Street 1:PO BOX 116638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6638
Mailing Address - Country:US
Mailing Address - Phone:423-495-4912
Mailing Address - Fax:423-495-4970
Practice Address - Street 1:4700 BATTLEFIELD PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5166
Practice Address - Country:US
Practice Address - Phone:706-861-4990
Practice Address - Fax:706-861-9405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4692210002Medicare NSC