| Healthcare For Seniors | |
|
2160 Fountain Drive 200 Snellville GA 30078-6783 | |
| (770) 982-1111 | |
| (770) 982-7280 |
| Full Name | Healthcare For Seniors |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2160 Fountain Drive, Snellville, Georgia |
| Authorized Official Name and Position | Jae H Pak (OWNER PHYSICIAN) |
| Authorized Official Contact | 7709821111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare For Seniors 2160 Fountain Drive 200 Snellville GA 30078-6783 Ph: (770) 982-1111 | Healthcare For Seniors 2160 Fountain Drive 200 Snellville GA 30078-6783 Ph: (770) 982-1111 |
| NPI Number | 1184706996 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 06/03/2016 |
| Medicare PECOS PAC ID | 5698719904 |
|---|---|
| Medicare Enrollment ID | O20050617000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184706996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 040185 (Georgia) | Primary |
| Provider Name | Jae H Pak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740280551 PECOS PAC ID: 6305887985 Enrollment ID: I20050513000051 |
| Provider Name | Jody L Amazon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427038470 PECOS PAC ID: 6709887755 Enrollment ID: I20070118000361 |
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