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Organization
RELIANCE FAMILY CARE
Active
Organization
RELIANCE FAMILY CARE
Active
Parent organization
LOCUST GROVE FAMILY MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOCUST GROVE FAMILY MEDICINE
Authorized official
MRS. NIMISHA J TRIVEDI MD (OWNER)
(678) 610-6649
Entity
Organization
Contact information
Practice address
345 HUNTINGTON PLACE CT, MCDONOUGH, GA 30253-8651
(678) 272-7280
(678) 610-6025
Mailing address
PO BOX 1100, LOCUST GROVE, GA 30248-8651
(678) 610-6649
(678) 610-6025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
053715
GA
Other
Enumeration date
01/21/2009
Last updated
03/03/2011
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