Provider Demographics
NPI:1780477893
Name:LIFELINE PRIMARY CARE, INC
Entity type:Organization
Organization Name:LIFELINE PRIMARY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AZIZ
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIRANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-559-3501
Mailing Address - Street 1:4855 RIVER GREEN PKWY STE 700
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8337
Mailing Address - Country:US
Mailing Address - Phone:770-545-8332
Mailing Address - Fax:678-868-1100
Practice Address - Street 1:8095 ROSWELL RD STE A
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-3931
Practice Address - Country:US
Practice Address - Phone:770-554-8332
Practice Address - Fax:678-868-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care