| Aid Atlanta Inc | |
|
770 Greison Trl Ste H Newnan GA 30263-6401 | |
| (770) 252-5418 | |
| (770) 252-5417 |
| Full Name | Aid Atlanta Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 770 Greison Trl Ste H, Newnan, Georgia |
| Authorized Official Name and Position | Lyle Honig Mojica (CFO) |
| Authorized Official Contact | 3238605305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aid Atlanta Inc 6255 W Sunset Blvd Fl 21 Los Angeles CA 90028-7422 Ph: (323) 860-5200 | Aid Atlanta Inc 770 Greison Trl Ste H Newnan GA 30263-6401 Ph: (770) 252-5418 |
| NPI Number | 1144646340 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 03/06/2024 |
| Medicare PECOS PAC ID | 4284866773 |
|---|---|
| Medicare Enrollment ID | O20140416000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144646340 | NPI | - | NPPES |
| 000519538A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Myrtle M Pearson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083786289 PECOS PAC ID: 3870554835 Enrollment ID: I20041022000503 |
| Provider Name | Alison Ann Lauber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245320977 PECOS PAC ID: 4688696545 Enrollment ID: I20051221000442 |
| Provider Name | Olivia D Bush |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861596231 PECOS PAC ID: 4284823816 Enrollment ID: I20110112000569 |
| Provider Name | Ahmed M Moussa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194989285 PECOS PAC ID: 3072796960 Enrollment ID: I20130918000234 |
| Provider Name | Delma D Gomez-adisa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861753816 PECOS PAC ID: 4880989219 Enrollment ID: I20160824002954 |
| Provider Name | James Dylan Lackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205403151 PECOS PAC ID: 9032515473 Enrollment ID: I20210909002101 |
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