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809 W Bankhead Hwy Suite D Villa Rica GA 30180-1520 | |
(770) 456-9993 | |
(770) 456-9949 |
Full Name | |
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Speciality | General Practice |
Location | 809 W Bankhead Hwy, Villa Rica, Georgia |
Authorized Official Name and Position | Warlito G Rollolazo (OWNER) |
Authorized Official Contact | 7704569993 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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809 W Bankhead Hwy Suite D Villa Rica GA 30180-1520 Ph: (770) 456-9993 | 809 W Bankhead Hwy Suite D Villa Rica GA 30180-1520 Ph: (770) 456-9993 |
NPI Number | 1851419410 |
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Provider Enumeration Date | 03/26/2007 |
Last Update Date | 06/13/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851419410 | NPI | - | NPPES |
143087983A | Medicaid | GA | |
000114133G | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | 17551 (Georgia) | Primary |
Nova Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20 Herrell Rd, Villa Rica, GA 30180 Phone: 770-726-7460 | |
Mcdowell & Co., Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 865 S Carroll Rd Ste C, Villa Rica, GA 30180 Phone: 770-459-4131 | |
Center For General Medicine Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 W. Hwy 78, Suite D, Villa Rica, GA 30180 Phone: 770-456-9996 Fax: 770-456-9949 | |
Veranet Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 403 Permian Way, Suite A, Villa Rica, GA 30180 Phone: 770-771-5235 Fax: 770-771-5236 |