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Organization
SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.
Active
Organization
SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.
Active
Other names
Southern Crescent Hospital for Specialty Care
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER KARAM (PRESIDENT & CEO)
(713) 277-2771
Entity
Organization
Contact information
Practice address
11 UPPER RIVERDALE RD SW, 6TH FLOOR, RIVERDALE, GA 30274-2615
(770) 897-7603
(770) 897-7606
Mailing address
11 UPPER RIVERDALE RD SW, 6TH FLOOR, RIVERDALE, GA 30274-2615
(770) 897-7603
(770) 897-7606
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
031-614
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109426A
—
GA
01
—
3397399
AETNA PVN
GA
01
—
7361505
AETNA PIN
GA
Enumeration date
10/10/2006
Last updated
08/03/2011
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