Provider Demographics
NPI:1942813381
Name:RARE DISEASE RESEARCH, LLC
Entity Type:Organization
Organization Name:RARE DISEASE RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-918-0380
Mailing Address - Street 1:1730 NORTHEAST EXPY NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2068
Mailing Address - Country:US
Mailing Address - Phone:404-918-0380
Mailing Address - Fax:
Practice Address - Street 1:1730 NORTHEAST EXPY NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30329-2068
Practice Address - Country:US
Practice Address - Phone:404-918-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RARE DISEASE RESEARCH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-25
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearchGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty