COOSA VALLEY WELLNESS, LLC
NPI 1003646902
Clinic/Center - Primary Care in Rome, GA

Q: What is Coosa Valley Wellness, LLC's NPI number?

The NPI number for Coosa Valley Wellness, LLC is 1003646902. It was assigned to this organization in the NPPES registry on August 5, 2024.

Q: What is Coosa Valley Wellness, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since August 05, 2024

4451 ALABAMA HWY NW STE 2, ROME, GA 30165(904) 302-3202(706) 739-7276 Get Directions Write a Review

NPPES record last updated: August 5, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Coosa Valley Wellness, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COOSA VALLEY WELLNESS, LLC (NPI 1003646902) is a healthcare organization registered as a primary care in Rome, Georgia and active in the NPI registry since August 2024. The organization lists Charlie Campbell, President, as its authorized official.

NPPES Registry Identity

NPI1003646902

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameCOOSA VALLEY WELLNESS, LLC

Location Address4451 ALABAMA HWY NW STE 2Rome, GA 30165-9200

Mailing Address4451 Alabama Hwy NwRome, GA 30165-9200 · (904) 302-3202 · Fax (706) 739-7276

Phone(904) 302-3202

Fax(706) 739-7276

Organization SubpartNo

Authorized OfficialCharlie CampbellPresident · (904) 302-3202

Enumeration DateAugust 5, 2024

NPPES CertifiedAugust 5, 2024

✔ NPI 1003646902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

4451 ALABAMA HWY NW STE 2, Rome, GA 30165

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2308869

Coosa Valley Wellness, LLC · Rome, GA

Expired · Aug 5, 2026

CLIA Number11D2308869

Laboratory TypePhysician Office

Certificate Effective DateAugust 6, 2024

Certificate Expiration DateAugust 5, 2026

Laboratory DirectorCharlie Campbell

Laboratory Phone(902) 302-3202

Laboratory LocationCoosa Valley Wellness, LLC4451 Alabama Highway, Suite 2, Rome, GA 30165

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Coosa Valley Wellness, LLC's NPI number?

The NPI number for Coosa Valley Wellness, LLC is 1003646902. It was assigned to this organization in the NPPES registry on August 5, 2024.

Where is Coosa Valley Wellness, LLC located?

Coosa Valley Wellness, LLC is located at 4451 Alabama Hwy NW Ste 2, Rome, GA 30165. The listed phone number is (904) 302-3202.

What is Coosa Valley Wellness, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Coosa Valley Wellness, LLC was last updated on August 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.