Provider Demographics
NPI:1871811588
Name:PRECISION HEALTHCARE
Entity type:Organization
Organization Name:PRECISION HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-541-0777
Mailing Address - Street 1:1000 PTREE IND BLVD
Mailing Address - Street 2:#6-306
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6737
Mailing Address - Country:US
Mailing Address - Phone:678-541-0777
Mailing Address - Fax:678-541-0780
Practice Address - Street 1:245 PTREE IND BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-9126
Practice Address - Country:US
Practice Address - Phone:678-541-0777
Practice Address - Fax:678-541-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH00060Medicare UPIN