Provider Demographics
NPI:1447691050
Name:SHIMLEY ENTERPRISES, LLC
Entity type:Organization
Organization Name:SHIMLEY ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHIMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-777-0790
Mailing Address - Street 1:11730 JONES BRIDGE RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5077
Mailing Address - Country:US
Mailing Address - Phone:770-777-0790
Mailing Address - Fax:770-777-0970
Practice Address - Street 1:11730 JONES BRIDGE RD
Practice Address - Street 2:SUITE E
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30005-5077
Practice Address - Country:US
Practice Address - Phone:770-777-0790
Practice Address - Fax:770-777-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty