Provider Demographics
NPI:1871729343
Name:PROGRESSIVE HEALTH PARTNERSHIPS
Entity type:Organization
Organization Name:PROGRESSIVE HEALTH PARTNERSHIPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:Z
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-715-9154
Mailing Address - Street 1:4040 CHAPEL HILL RD STE Q
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-2763
Mailing Address - Country:US
Mailing Address - Phone:678-715-9154
Mailing Address - Fax:678-715-9159
Practice Address - Street 1:4040 CHAPEL HILL RD STE Q
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2763
Practice Address - Country:US
Practice Address - Phone:678-715-9154
Practice Address - Fax:678-715-9159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care