Individual ProviderBarath Prashanth SivasubramanianInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address743 Spring St NE Rear 710, Gainesville, GA 30501-3899(770) 219-8730PECOS EnrollmentBased on the most recent information from CMS, provider Barath Prashanth Sivasubramanian is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1245071752Provider TypeIndividualFull NameSivasubramanian, Barath PrashanthGenderMaleSole ProprietorNoEnumeration Date6/6/2024Last Updated6/26/2024Contact InformationPractice LocationPractice Address743 Spring St NE Rear 710, Gainesville, GA 30501-3899Phone(770) 219-8730FaxUnlisted FaxMailing LocationMailing Address743 Spring St NE Rear 710, Gainesville, GA 30501-3899Phone(770) 219-8730FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense16578Georgia