Provider Demographics
NPI:1174592703
Name:ROME WELLNESS DIAGNOSTICS
Entity type:Organization
Organization Name:ROME WELLNESS DIAGNOSTICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARENSCHIELD
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:281-381-8838
Mailing Address - Street 1:3100 TIMMONS LN
Mailing Address - Street 2:SUITE 320
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5926
Mailing Address - Country:US
Mailing Address - Phone:713-840-0808
Mailing Address - Fax:713-840-0881
Practice Address - Street 1:18 RIVERBEND DR SW
Practice Address - Street 2:SUITE 230
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-6013
Practice Address - Country:US
Practice Address - Phone:706-314-0019
Practice Address - Fax:706-314-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032965261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA29BDCPHMedicare PIN
GA13BDDSZMedicare PIN
GAGRP6367Medicare ID - Type Unspecified
GA11SCCPPMedicare PIN