Provider Demographics
NPI:1669539508
Name:THE HEALTHCARING CLINIC OF GEORGIA, LLC
Entity type:Organization
Organization Name:THE HEALTHCARING CLINIC OF GEORGIA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSCALZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-907-2661
Mailing Address - Street 1:P.O. BOX 681765
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37068-1765
Mailing Address - Country:US
Mailing Address - Phone:866-862-7276
Mailing Address - Fax:502-423-1699
Practice Address - Street 1:491 EAST MAIN ST.
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121
Practice Address - Country:US
Practice Address - Phone:678-535-1170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HEALTHCARING COMPANY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1669539508OtherNPI
GAGRP7984OtherMEDICARE PTAN