Eidex Testing Center | |
1276 Mcconnell Dr Ste A Decatur GA 30033-3533 | |
(404) 321-0250 | |
(404) 321-3535 |
Full Name | Eidex Testing Center |
---|---|
Speciality | Psychologist |
Location | 1276 Mcconnell Dr Ste A, Decatur, Georgia |
Authorized Official Name and Position | Rivkah M Eidex (PSYCHOLOGIST) |
Authorized Official Contact | 4043210250 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Eidex Testing Center 1276 Mcconnell Dr Ste A Decatur GA 30033-3533 Ph: (404) 321-0250 | Eidex Testing Center 1276 Mcconnell Dr Ste A Decatur GA 30033-3533 Ph: (404) 321-0250 |
NPI Number | 1447545090 |
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Provider Enumeration Date | 06/12/2011 |
Last Update Date | 08/04/2011 |
Medicare PECOS PAC ID | 0941479380 |
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Medicare Enrollment ID | O20110801000867 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447545090 | NPI | - | NPPES |
000902217A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 2499 (Georgia) | Primary |
Provider Name | Rivkah M Eidex |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1760588008 PECOS PAC ID: 1355426073 Enrollment ID: I20080305000444 |
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