| Nithyasri Llc | |
|
2151 Peachford Rd Atlanta GA 30338-6534 | |
| (770) 455-3200 | |
| (770) 455-3200 |
| Full Name | Nithyasri Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2151 Peachford Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Ramkanth Vemuluri (OWNER) |
| Authorized Official Contact | 3344143333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nithyasri Llc 10525 Grandview Sq Duluth GA 30097-2518 Ph: (334) 414-3333 | Nithyasri Llc 2151 Peachford Rd Atlanta GA 30338-6534 Ph: (770) 455-3200 |
| NPI Number | 1225806292 |
|---|---|
| Provider Enumeration Date | 12/19/2023 |
| Last Update Date | 01/23/2024 |
| Certification Date | 01/23/2024 |
| Medicare PECOS PAC ID | 5890148407 |
|---|---|
| Medicare Enrollment ID | O20240131001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225806292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ramakanth K Vemuluri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922208222 PECOS PAC ID: 8729258223 Enrollment ID: I20191210000198 |
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