Provider Demographics
NPI:1982857710
Name:NIMCO L.L.C
Entity Type:Organization
Organization Name:NIMCO L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:J.
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:CRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-767-6400
Mailing Address - Street 1:3290 NORTHSIDE PARKWAY NW
Mailing Address - Street 2:SUITE #300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-767-6400
Mailing Address - Fax:407-767-6476
Practice Address - Street 1:3290 NORTHSIDE PARKWAY NW
Practice Address - Street 2:SUITE #300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:404-767-6400
Practice Address - Fax:407-767-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA329432084N0400X, 246Z00000X, 246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty