Organization
LIFELINE PRIMARY CARE, INC
Active
Parent organization
LIFELINE PRIMARY CARE, INC
Other names
Lifeline Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFELINE PRIMARY CARE, INC
Authorized official
MS. BRINA LYNN ROLISON (BUSINESS DEVELOPMENT)
(678) 775-9344
Entity
Organization
Contact information
Practice address
4855 RIVER GREEN PKWY, BUILDING 7, SUITE 700, DULUTH, GA 30096-8336
(678) 775-9344
Mailing address
4855 RIVER GREEN PKWY, BUILDING 7, SUITE 700, DULUTH, GA 30096-8336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
056624
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267992339B
—
GA
Enumeration date
08/19/2015
Last updated
08/08/2024
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