| Bivins Enterprise, Llc | |
|
30 Rosemoore Dr Covington GA 30014-7065 | |
| (404) 820-0964 | |
| Not Available |
| Full Name | Bivins Enterprise, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 30 Rosemoore Dr, Covington, Georgia |
| Authorized Official Name and Position | Valerie Elaine Fanning (PRESIDENT) |
| Authorized Official Contact | 4048200964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bivins Enterprise, Llc 5486 Somersby Pkwy Pinson AL 35126-5512 Ph: (140) 482-0096 | Bivins Enterprise, Llc 30 Rosemoore Dr Covington GA 30014-7065 Ph: (404) 820-0964 |
| NPI Number | 1902495179 |
|---|---|
| Provider Enumeration Date | 01/13/2021 |
| Last Update Date | 01/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902495179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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