| Covenant Medical Center Pc | |
|
3970 Five Forks Trickum Rd Sw Suite A Lilburn GA 30047-2339 | |
| (678) 357-1282 | |
| Not Available |
| Full Name | Covenant Medical Center Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3970 Five Forks Trickum Rd Sw, Lilburn, Georgia |
| Authorized Official Name and Position | Cecilia O Babalola (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6783571282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Medical Center Pc 3970 Five Forks Trickum Rd Sw Suite A Lilburn GA 30047-2339 Ph: (678) 357-1282 | Covenant Medical Center Pc 3970 Five Forks Trickum Rd Sw Suite A Lilburn GA 30047-2339 Ph: (678) 357-1282 |
| NPI Number | 1770726721 |
|---|---|
| Provider Enumeration Date | 04/07/2009 |
| Last Update Date | 04/20/2010 |
| Medicare PECOS PAC ID | 8628120169 |
|---|---|
| Medicare Enrollment ID | O20090715000204 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770726721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 058389 (Georgia) | Primary |
| Provider Name | Cecilia O Babalola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649315417 PECOS PAC ID: 3274619853 Enrollment ID: I20080324000154 |
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