Core Healthcare Services | |
2131 Kingston Ct Se Ste 108 Marietta GA 30067-8929 | |
(678) 772-7415 | |
(678) 804-6883 |
Full Name | Core Healthcare Services |
---|---|
Speciality | Community/Behavioral Health |
Location | 2131 Kingston Ct Se Ste 108, Marietta, Georgia |
Authorized Official Name and Position | Augusta Williams (NP) |
Authorized Official Contact | 6788875083 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Core Healthcare Services 174 Thorncliff Way Acworth GA 30101-2644 Ph: () - | Core Healthcare Services 2131 Kingston Ct Se Ste 108 Marietta GA 30067-8929 Ph: (678) 772-7415 |
NPI Number | 1982942934 |
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Provider Enumeration Date | 01/26/2013 |
Last Update Date | 12/29/2020 |
Certification Date | 12/29/2020 |
Medicare PECOS PAC ID | 4880007095 |
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Medicare Enrollment ID | O20210107002155 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982942934 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Augusta Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407402910 PECOS PAC ID: 6901234384 Enrollment ID: I20210107002391 |
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