| Biotech Lab Llc | |
|
2709 Airport Rd Dalton GA 30721-0252 | |
| (706) 275-4444 | |
| (706) 275-6515 |
| Full Name | Biotech Lab Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2709 Airport Rd, Dalton, Georgia |
| Authorized Official Name and Position | Holly Bullock (PRACTICE MANAGER) |
| Authorized Official Contact | 7062754444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Biotech Lab Llc 2709 Airport Rd Dalton GA 30721-0252 Ph: (706) 275-4444 | Biotech Lab Llc 2709 Airport Rd Dalton GA 30721-0252 Ph: (706) 275-4444 |
| NPI Number | 1558141135 |
|---|---|
| Provider Enumeration Date | 10/02/2023 |
| Last Update Date | 10/27/2023 |
| Medicare PECOS PAC ID | 4284082710 |
|---|---|
| Medicare Enrollment ID | O20231122001036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558141135 | NPI | - | NPPES |
| 1447304316 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gretchen Diaz-lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447304316 PECOS PAC ID: 3476453770 Enrollment ID: I20040112000389 |
| Provider Name | Thomas L Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710144324 PECOS PAC ID: 7012051980 Enrollment ID: I20100216000130 |
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Mednow, Inc, Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2709 Airport Rd, Suite 101, Dalton, GA 30721 Phone: 706-275-4444 Fax: 706-275-6515 | |
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