Provider Demographics
NPI:1952667628
Name:UNI-ONE MEDICAL CLINIC LLC
Entity Type:Organization
Organization Name:UNI-ONE MEDICAL CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-576-9732
Mailing Address - Street 1:PO BOX 5850
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-5850
Mailing Address - Country:US
Mailing Address - Phone:770-576-9732
Mailing Address - Fax:678-281-7553
Practice Address - Street 1:300 N MAIN ST
Practice Address - Street 2:SUITE 306
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3296
Practice Address - Country:US
Practice Address - Phone:770-576-9732
Practice Address - Fax:678-281-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-07
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care