Provider Demographics
NPI:1285879833
Name:TMC CAROUSEL PEDIATRICS INC
Entity type:Organization
Organization Name:TMC CAROUSEL PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:MACALUSO-PEARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-838-8554
Mailing Address - Street 1:804 DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4416
Mailing Address - Country:US
Mailing Address - Phone:770-834-0606
Mailing Address - Fax:770-834-1833
Practice Address - Street 1:119 AMBULANCE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3857
Practice Address - Country:US
Practice Address - Phone:770-834-0606
Practice Address - Fax:770-834-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty