ROYAL BLUE MEDICAL CENTER GA. INC (NPI# 1942845417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942845417 |
| Entity Type | Organization |
| Organization Name | ROYAL BLUE MEDICAL CENTER GA. INC |
| Other Organization Name | ROYAL BLUE MEDICAL CENTER |
| Practice Address |
555 Old Norcross Rd Ste 100 Lawrenceville GA 30046-8703 |
| Mailing Address |
2023 Connonade Dr Waxhaw NC 28173-0109 |
| Practice Telephone | 7042771750 |
| Mailing Telephone | 7042771750 |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | MR. OMAR ELLISON (OWNER) |
| Authorized Official Telephone | 7042771750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Royal Blue Medical Center | Doing Business As Name - Organization |
| Street Address |
555 OLD NORCROSS RD STE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962493502 | Daniel Reif Daugherty | Family Medicine | 555 Old Norcross Rd Ste 100, Clear Choice Family Medicine, Lawrenceville, GA 30046-8703 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184089831 | Louis Guy Chelton IIi | General Practice | 80 Rivershyre Cir, Lawrenceville, GA 30043-6436 | 2015-12-23 |
| 1699238097 | Regional Electrodiagnostics LLC | General Practice | 2141 Us Highway 1, Lawrenceville, NJ 08648-4407 | 2019-04-11 |
| 1013265479 | Ac Spine & Wellness Center LLC | General Practice | 217 Scenic Hwy # 124, Lawrenceville, GA 30046-5621 | 2012-08-16 |
| 1861620346 | Jessica Bowers-pepe Do PC | General Practice | 4 Princess Rd, Suite 204, Lawrenceville, NJ 08648-2322 | 2009-06-23 |
| 1932336013 | Compass Health Associates, PC | General Practice | 136 Franklin Corner Rd, Lawrenceville, NJ 08648-2502 | 2009-06-16 |
| 1154564730 | Mosaic Family Health | General Practice | 136 Franklin Corner Rd, Lawrenceville, NJ 08648-2502 | 2009-04-13 |
| 1710088505 | Hoyt Wayborn Gazaway Jr. | General Practice | 771 Old Norcross Rd, Suite 255, Lawrenceville, GA 30046-4386 | 2006-09-26 |
| 1841233905 | Sylvia Marie Halleck | General Practice | 1431 Riverside Pkwy, Suite B, Lawrenceville, GA 30043-5946 | 2006-06-14 |
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| 1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
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| City | LAWRENCEVILLE |
| Zip Code | 30046 |
Please comment or provide details below to improve the information on ROYAL BLUE MEDICAL CENTER GA. INC.
| 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.