| Athletico Ltd | |
|
2205 Jefferson Davis Dr Oxford MS 38655-5221 | |
| (662) 238-2800 | |
| (662) 238-2808 |
| Full Name | Athletico Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 2205 Jefferson Davis Dr, Oxford, Mississippi |
| Authorized Official Name and Position | Juana Granados (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6305751980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Athletico Ltd 2122 York Rd Ste 300 Oak Brook IL 60523-1925 Ph: (630) 575-1980 | Athletico Ltd 2205 Jefferson Davis Dr Oxford MS 38655-5221 Ph: (662) 238-2800 |
| NPI Number | 1053195990 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/22/2023 |
| Medicare PECOS PAC ID | 4789602681 |
|---|---|
| Medicare Enrollment ID | O20231018003487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053195990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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