Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Greenline Medical Corporation

Organization General Practice Physician · NPI 1073810453

Greenline Medical Corporation provides General Practice Physician services in Roswell, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011
Specialties on file
2

Practice location Address checks out

804 Bombay Ln
Roswell, GA 30076-5819 Not confirmed with CMS for 15 years — call before visiting
Phone: (770) 754-9880
Fax: (770) 754-9881
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 058478 (GA)
Pain Medicine Physician Taxonomy 208VP0000X · Licence 058478 (GA)

Record details

NPI number1073810453
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Green — Physician · (770) 754-9880
Other names Eagle Medical Center
NPI enumeratedFebruary 19, 2011
Last updated in NPPESFebruary 19, 2011
Mailing address804 Bombay Ln, Roswell, GA 30076-5819

Other providers in Roswell