PRIME HEALTHCARE FOUNDATION - SOUTHERN REGIONAL, LLC


Address: 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615
Phone: 7709918000

PRIME HEALTHCARE FOUNDATION - SOUTHERN REGIONAL, LLC (NPI# 1154795581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154795581
Entity Type Organization
Organization Name PRIME HEALTHCARE FOUNDATION - SOUTHERN REGIONAL, LLC
Practice Address 11 Upper Riverdale Rd Sw
Riverdale
GA 30274-2615
Practice Telephone 7709918000
Mailing Telephone 7709918000
Enumeration Date 2015-11-23
Last Update Date 2017-02-23
Authorized Official Name CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
Authorized Official Telephone 9092354307
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians
Y 282N00000X General Acute Care Hospital 031-442 GA Hospitals

Other Provider Identifier

State Issuer Identifier Type Code
GA 00000404A 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1518440254 Prime Healthcare Foundation - Southern Regional, LLC Psychiatric Unit 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2018-09-10
1679946669 Prime Healthcare Foundation - Southern Regional, LLC Rehabilitation Unit 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2015-11-12

Office Location

Street Address 11 UPPER RIVERDALE RD SW
City RIVERDALE
State GA
Zip Code 30274-2615

Providers in the same location

NPI Name Taxonomy Address Enumeration
1831190958 Southern Regional Health System, Inc General Acute Care Hospital 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2005-08-10
1639796212 Georgia Em-i Medical Service PC Physician Assistant 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2020-06-30
1093331308 Harmony Grove Emergency Physicians LLC Emergency Medicine 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2020-06-23
1366092827 Evan Chandler Burrowes Dietitian, Registered 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2019-09-17
1932676681 Ashley Lauren King Physician Assistant 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2018-10-31
1518440254 Prime Healthcare Foundation - Southern Regional, LLC Psychiatric Unit 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2018-09-10
1730660093 Virginia Tittle Kee Nurse Practitioner 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2018-08-24
1245724723 Kelly Henry Registered Nurse 11 Upper Riverdale Rd Sw, Riverdale, GA 30274 2018-06-19
1053821777 Angelyn Levell-smith Nurse Practitioner 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2017-10-08
1932625548 Lpp of Georgia LLC Emergency Medicine 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2017-08-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1245862507 Todd L. Reed Chiropractor 83 Upper Riverdale Rd, Riverdale, GA 30274 2020-02-05
1487135992 Freddie L Sallette IIi Technician, Pathology 385 Brookview Dr, Riverdale, GA 30274 2018-08-22
1366933210 Dawn A. Paul Nurse Practitioner 238 Professional Ct Ste A, Riverdale, GA 30274 2018-05-27
1851894588 Absolute Health Family & Urgent Care Clinic Clinic/Center 7574 Ga 85, Riverdale, GA 30274 2018-03-08
1366972127 Jamillah Ingram Physical Therapy Assistant 315 Upper Riverdale Rd., Riverdale, GA 30274 2017-06-14
1114456514 Grace L Kelson Licensed Practical Nurse 9142 Clubhouse Dr, Riverdale, GA 30274 2017-06-08
1790167799 Cristian Carbuccia Internal Medicine 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 2015-06-25
1265857692 Right Choice Enterprises LLC Technician 638 Sterling Ct, Riverdale, GA 30274 2014-02-21
1942571625 Lowes Guardian Angel LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 7056 Eunice Dr., Riverdale, GA 30274 2012-01-26
1508134156 Education System Management, Inc Social Worker 125 Highway 138, Riverdale, GA 30274 2011-12-12
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Taxonomy Information

Taxonomy Code 282N00000X
Grouping Hospitals
Classification General Acute Care Hospital

Taxonomy Definition

An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649645011 Clarence Waugh General Acute Care Hospital 171 Sterling Ridge Dr, Riverdale, GA 30274-4637 2015-12-09
1831190958 Southern Regional Health System, Inc General Acute Care Hospital 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 2005-08-10
1558814459 Atlanta Kidney Specialists LLC General Acute Care Hospital 253 Upper Riverdale Rd Sw, Suite B, Riverdale, GA 30274-4945 2016-07-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902459316 Au Medical Center, Inc General Acute Care Hospital 1348 Walton Way Ste 6300c, Augusta, GA 30901-5104 2019-07-24
1841651056 Kamran Rajaee General Acute Care Hospital 5081 Sunset Trl, Marietta, GA 30068-4734 2016-03-15
1144687070 Globale, LLC General Acute Care Hospital 750 Dalrymple Rd Apt B2, Atlanta, GA 30328-1434 2016-01-22
1548632045 Allbright Professional Blood Services General Acute Care Hospital 1043 River Forest Pt, Lawrenceville, GA 30045-2600 2015-10-22
1790173094 Piedmont Healthcare General Acute Care Hospital 2124 Mckinley Rd Nw, Atlanta, GA 30318-1708 2015-01-08
1790183622 Pauline L. Jacinto Md General Acute Care Hospital 104 Lakeshore Dr Ste B, Saint Marys, GA 31558-3809 2014-12-09
1073937892 Emory University Hospital General Acute Care Hospital 5207 Peachtree Creek Cir, Atlanta, GA 30341-5364 2014-02-13
1063856706 Keystone Surgical Associates General Acute Care Hospital 2525 Kirk Pointe Cv Nw, Kennesaw, GA 30152-6239 2013-04-24
1679810022 Proficiency Scribes Cs, LLC General Acute Care Hospital 114 Bradley Rd, Jackson, GA 30233-3702 2013-01-04
1891045191 South Georgia Medical Center General Acute Care Hospital 2501 North Patterson St, Valdosta, GA 31636 2012-09-13
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Competitor

Search similar providers

City RIVERDALE
Zip Code 30274

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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