| Art Pharmacy | |
|
977 Manigault St Se Atlanta GA 30316-1311 | |
| (404) 376-3280 | |
| Not Available |
| Full Name | Art Pharmacy |
|---|---|
| Speciality | Social Worker |
| Location | 977 Manigault St Se, Atlanta, Georgia |
| Authorized Official Name and Position | Chris Appleton (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4043763280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Art Pharmacy 977 Manigault St Se Atlanta GA 30316-1311 Ph: (404) 376-3280 | Art Pharmacy 977 Manigault St Se Atlanta GA 30316-1311 Ph: (404) 376-3280 |
| NPI Number | 1104535855 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Medicare PECOS PAC ID | 6709245798 |
|---|---|
| Medicare Enrollment ID | O20230710000734 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104535855 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Jacye A Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245545946 PECOS PAC ID: 7012384027 Enrollment ID: I20221103003416 |
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