Provider Demographics
NPI:1215666318
Name:JOY PEDIATRIC,LLC
Entity type:Organization
Organization Name:JOY PEDIATRIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:706-237-7314
Mailing Address - Street 1:101 ELLIOTT DR NW STE D
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1154
Mailing Address - Country:US
Mailing Address - Phone:706-237-7314
Mailing Address - Fax:
Practice Address - Street 1:101 ELLIOTT DR NW STE D
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1154
Practice Address - Country:US
Practice Address - Phone:706-237-7314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care