Organization · NPI-2

Southeast Atlanta Vascular Care, LLC

· Lithonia, GA

NPI number1922549237

StatusActive

Last updated in NPPESMar 20, 2017

Details

NPI: 1922549237
Entity type: Organization (NPI-2)
Legal business name: Southeast Atlanta Vascular Care, LLC
Organization subpart: No
Enumeration date: Mar 20, 2017
Last updated: Mar 20, 2017

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2086S0129X		–	–	Yes
2085R0204X	Radiology, Vascular & Interventional Radiology	–	–

Practice location

5461 Hillandale Dr
Suite 210
Lithonia, GA 30058-4841

Phone 770-981-8477 · Fax 770-981-8908

Mailing address

9140 Corsea Del Fontana Way
Naples, FL 34109-4397

Phone 239-597-2010 · Fax 239-597-2313

Authorized official

Lisa Mcnamara
Evp
2395972010

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