Provider Demographics
NPI:1295126514
Name:PAULDING MEDICAL CENTER INC
Entity type:Organization
Organization Name:PAULDING MEDICAL CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:SNEHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:470-644-0392
Mailing Address - Street 1:144 BILL CARRUTH PARKWAY
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141
Mailing Address - Country:US
Mailing Address - Phone:470-644-8095
Mailing Address - Fax:470-644-7353
Practice Address - Street 1:144 BILL CARRUTH PKWY
Practice Address - Street 2:SUITE 2000
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3818
Practice Address - Country:US
Practice Address - Phone:470-644-8095
Practice Address - Fax:470-644-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-09
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0100983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003181683AMedicaid
2149474OtherPK