Provider Demographics
NPI:1730338005
Name:HYPERBARIC RESEARCH AND TREATMENT CENTER
Entity type:Organization
Organization Name:HYPERBARIC RESEARCH AND TREATMENT CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-736-7331
Mailing Address - Street 1:4250 STONE MOUNTAIN HWY # 78
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3340
Mailing Address - Country:US
Mailing Address - Phone:770-736-7331
Mailing Address - Fax:770-736-7764
Practice Address - Street 1:4250 STONE MOUNTAIN HWY # 78
Practice Address - Street 2:SUITE 100
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3340
Practice Address - Country:US
Practice Address - Phone:770-736-7331
Practice Address - Fax:770-736-7764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty