Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 13 Peach St, Butler, Georgia |
Authorized Official Name and Position | Bedis Zormati (OWNER) |
Authorized Official Contact | 2125186900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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441 Lexington Ave Rm 1221 New York NY 10017-3931 Ph: (212) 518-6900 | 13 Peach St Butler GA 31006-5338 Ph: (212) 518-6900 |
NPI Number | 1336868843 |
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Provider Enumeration Date | 08/26/2022 |
Last Update Date | 08/26/2022 |
Medicare PECOS PAC ID | 6507235785 |
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Medicare Enrollment ID | O20230117002423 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336868843 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
Decker Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18 S Broad St, Butler, GA 31006 Phone: 478-837-7121 Fax: 478-837-7020 | |