Education System Management, Inc | |
125 Highway 138 Riverdale GA 30274 | |
(770) 742-0265 | |
(770) 742-0862 |
Full Name | Education System Management, Inc |
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Speciality | Clinical Medical Laboratory |
Location | 125 Highway 138, Riverdale, Georgia |
Authorized Official Name and Position | Carroll Braddy (CEO) |
Authorized Official Contact | 7708925284 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Education System Management, Inc 1115 Mount Zion Rd Suite C Morrow GA 30260-2266 Ph: (770) 742-0265 | Education System Management, Inc 125 Highway 138 Riverdale GA 30274 Ph: (770) 742-0265 |
NPI Number | 1508134156 |
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Provider Enumeration Date | 12/12/2011 |
Last Update Date | 01/06/2022 |
Certification Date | 01/06/2022 |
Medicare PECOS PAC ID | 1456743830 |
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Medicare Enrollment ID | O20220114000675 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508134156 | NPI | - | NPPES |
003148586A | Medicaid | GA | |
003168151A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | CSW003727 (Georgia) | Secondary |
291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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