Provider Demographics
NPI:1366082596
Name:ROCK HEALTH INC
Entity type:Organization
Organization Name:ROCK HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:404-822-4051
Mailing Address - Street 1:382 SUMMER GLEN CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-5500
Mailing Address - Country:US
Mailing Address - Phone:404-822-4051
Mailing Address - Fax:
Practice Address - Street 1:5385 FIVE FORKS TRICKUM RD STE F
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3018
Practice Address - Country:US
Practice Address - Phone:404-822-4051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care