| 1st Choice Telemedicine Llc | |
|
1500 Rock Quarry Rd Stockbridge GA 30281-5047 | |
| (678) 722-5778 | |
| Not Available |
| Full Name | 1st Choice Telemedicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 Rock Quarry Rd, Stockbridge, Georgia |
| Authorized Official Name and Position | Bennie Lee Brown (CEO) |
| Authorized Official Contact | 2293951253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 1st Choice Telemedicine Llc 1500 Rock Quarry Rd Stockbridge GA 30281-5047 Ph: (678) 722-5778 | 1st Choice Telemedicine Llc 1500 Rock Quarry Rd Stockbridge GA 30281-5047 Ph: (678) 722-5778 |
| NPI Number | 1285193474 |
|---|---|
| Provider Enumeration Date | 03/18/2019 |
| Last Update Date | 05/21/2023 |
| Medicare PECOS PAC ID | 9830555994 |
|---|---|
| Medicare Enrollment ID | O20230515002752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285193474 | NPI | - | NPPES |
| 003139672C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Bennie L Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770570236 PECOS PAC ID: 5597749333 Enrollment ID: I20131119000949 |
| Provider Name | Shuvory C Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487994901 PECOS PAC ID: 9436373602 Enrollment ID: I20140609000631 |
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