Organization · Type 2 NPI

Memorial Health Partners Foundation, Inc.

Non-Pharmacy Dispensing Site · La Fayette, GA

NPI number 1669861530 Active

Practice location

611 E Villanow St
La Fayette, GA 30728-2618

Fax (706) 638-9987

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	None listed

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

8 other providers at this address

NPI record

NPI: 1669861530
Entity type: Organization (Type 2)
Issued: Jan 15, 2015
Last updated: Jan 15, 2015
Status: Active
Subpart: Yes of Memorial Health Partners Foundation, Inc.

Other names

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Professional Park Associates · doing business as

Authorized official

Ramon Figueroa
Director Physician Operations
(423) 424-1551

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669861530

Memorial Health Partners Foundation, Inc.'s National Provider Identifier is 1669861530, issued on Jan 15, 2015. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in La Fayette, GA. The record was last updated on Jan 15, 2015.