| Charis Healthcare Llc | |
|
2365 Powder Springs Rd Sw Ste 1103 Marietta GA 30064-4574 | |
| (470) 604-9800 | |
| (470) 604-9900 |
| Full Name | Charis Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2365 Powder Springs Rd Sw Ste 1103, Marietta, Georgia |
| Authorized Official Name and Position | Ibijoke Solanke (MANAGER) |
| Authorized Official Contact | 4706049800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charis Healthcare Llc 3936 Hemingway Dr Powder Springs GA 30127-5094 Ph: () - | Charis Healthcare Llc 2365 Powder Springs Rd Sw Ste 1103 Marietta GA 30064-4574 Ph: (470) 604-9800 |
| NPI Number | 1447856653 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 01/09/2023 |
| Medicare PECOS PAC ID | 2668885260 |
|---|---|
| Medicare Enrollment ID | O20201228001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447856653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ibijoke Olubunmi Solanke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831677582 PECOS PAC ID: 1658657549 Enrollment ID: I20201228001383 |
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