Elite Rehab And Weightloss is a medicare enrolled "Clinic/center - Multi-specialty" provider in Morrow, Georgia. Their current practice location is
1568 Southlake Pkwy Ste C, Morrow, Georgia. You can reach out to their office (for appointments etc.) via phone at
(470) 878-0696.
Elite Rehab And Weightloss is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Elite Rehab And Weightloss
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1043679418.
Healthcare Provider's Profile
| Full Name | Elite Rehab And Weightloss |
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| Type | Facility |
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| Speciality | Clinic/center - Multi-specialty |
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| Location | 1568 Southlake Pkwy Ste C, Morrow, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043679418
- Provider Enumeration Date: 02/15/2016
- Last Update Date: 02/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 7517303613
- Enrollment ID: O20240312001492
Medical Identifiers
Medical identifiers for Elite Rehab And Weightloss such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043679418 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | CHIR006798 (Georgia) | Secondary |
| 111NR0400X | Chiropractor - Rehabilitation | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Elite Rehab And Weightloss acts as a billing entity for following providers:
| Provider Name | Victor Osisanya |
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| Provider Type | Practitioner - Pain Management |
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| Provider Identifiers | NPI Number: 1679884753
PECOS PAC ID: 8628393451
Enrollment ID: I20150218002209 |
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| Provider Name | Vandy Gaffney |
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| Provider Type | Practitioner - Anesthesiology |
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| Provider Identifiers | NPI Number: 1730470329
PECOS PAC ID: 3274776869
Enrollment ID: I20170509001065 |
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| Provider Name | Anslie Prudhomme |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1285126391
PECOS PAC ID: 9234574641
Enrollment ID: I20240226001094 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Elite Rehab And Weightloss is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Elite Rehab And Weightloss
1568 Southlake Pkwy Ste C,
Morrow, GA 30260-4153
Ph: (470) 878-0696 | Elite Rehab And Weightloss
1568 Southlake Pkwy Ste C,
Morrow, GA 30260
Ph: (470) 878-0696 |
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