Provider Demographics
NPI:1942533435
Name:ATHENS LIMESTONE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ATHENS LIMESTONE HEALTH SERVICES LLC
Other - Org Name:ATHENS LIMESTONE PEDIATRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-233-9172
Mailing Address - Street 1:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35612-0999
Mailing Address - Country:US
Mailing Address - Phone:256-216-9730
Mailing Address - Fax:256-216-9731
Practice Address - Street 1:101 FITNESS WAY
Practice Address - Street 2:SUITE 2100
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2480
Practice Address - Country:US
Practice Address - Phone:256-216-9730
Practice Address - Fax:256-216-9731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty