# CHIMED FIC SA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447839196
- **Authorized official:** DR. STEPHEN COOPER (MANAGER)
- **Authorized official phone:** (877) 495-7773

## Contact information

- **Practice address:** 541 FOREST PKWY STE 14, FOREST PARK, GA 30297-6110
- **Practice address phone:** (877) 495-7773
- **Mailing address:** PO BOX 1601, PHENIX CITY, AL 36868-1601
- **Mailing address phone:** (334) 298-7700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 04/07/2021
- **Last updated:** 04/07/2021