| Carehalo Alabama Llc | |
|
5200 Dallas Hwy Ste 200-243 Powder Springs GA 30127-6318 | |
| (770) 364-2184 | |
| Not Available |
| Full Name | Carehalo Alabama Llc |
|---|---|
| Speciality | General Practice |
| Location | 5200 Dallas Hwy Ste 200-243, Powder Springs, Georgia |
| Authorized Official Name and Position | Tamika S Goins (MANAGER) |
| Authorized Official Contact | 7703642184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carehalo Alabama Llc 5200 Dallas Hwy Ste 200-243 Powder Springs GA 30127-6318 Ph: (770) 364-2184 | Carehalo Alabama Llc 5200 Dallas Hwy Ste 200-243 Powder Springs GA 30127-6318 Ph: (770) 364-2184 |
| NPI Number | 1467009217 |
|---|---|
| Provider Enumeration Date | 08/26/2019 |
| Last Update Date | 08/26/2019 |
| Medicare PECOS PAC ID | 6204264740 |
|---|---|
| Medicare Enrollment ID | O20200317001626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467009217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Lanesha Bracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447590385 PECOS PAC ID: 8426299025 Enrollment ID: I20130724000510 |
| Provider Name | Tabbata C Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649833666 PECOS PAC ID: 0345574364 Enrollment ID: I20190625003947 |
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