Organization
TANNER MEDICAL CENTER, INC.
Active
Parent organization
TANNER MEDICAL CENTER
Other names
Tanner Medical Center Villa Rica BH
Organization subpart
Yes
Provider details
NPI number
Legal business name
TANNER MEDICAL CENTER
Authorized official
CAROL CREWS (CFO)
(770) 836-9745
Entity
Organization
Contact information
Practice address
101 QUARTZ DR STE 103A, VILLA RICA, GA 30180-3256
(770) 456-3266
Mailing address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 836-9666
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
NOT REQUIRED
—
251S00000X
Community/Behavioral Health Agency
Primary
NOT REQUIRED
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871502260
ORGANIZATIONAL NPI
GA
05
—
296667723B
—
GA
01
—
300027104A
MEDICAID PAYEE IDENTIFICATION NUMBER
GA
Enumeration date
02/12/2010
Last updated
05/10/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us