Organization
PLANNED PARENTHOOD SOUTHEAST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SAMANTHA DENISE GAGANIS (PRACTICE MANAGER)
(404) 688-9305
Entity
Organization
Contact information
Practice address
440 MORELAND AVE SE, ATLANTA, GA 30316-1926
(404) 688-9305
(404) 688-0621
Mailing address
241 PEACHTREE ST NE STE 400, ATLANTA, GA 30303-1423
(404) 688-9300
(404) 688-0621
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000052005A
—
GA
01
—
GA1005
SOUTH CAROLINA MEDICAID
SC
01
—
GA16213
SOUTH CAROLINA MEDICAID
SC
Enumeration date
05/18/2006
Last updated
01/14/2021
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