| Family First Healthcare P.c. | |
|
939 Thornton Rd Lithia Springs GA 30122-2634 | |
| (770) 739-1233 | |
| (770) 948-4930 |
| Full Name | Family First Healthcare P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 939 Thornton Rd, Lithia Springs, Georgia |
| Authorized Official Name and Position | Bryan D Blake (OWNER) |
| Authorized Official Contact | 7707391233 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family First Healthcare P.c. 939 Thornton Rd Lithia Springs GA 30122-2634 Ph: (770) 739-1233 | Family First Healthcare P.c. 939 Thornton Rd Lithia Springs GA 30122-2634 Ph: (770) 739-1233 |
| NPI Number | 1730315870 |
|---|---|
| Provider Enumeration Date | 06/03/2009 |
| Last Update Date | 02/03/2012 |
| Medicare PECOS PAC ID | 7810047974 |
|---|---|
| Medicare Enrollment ID | O20090610000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730315870 | NPI | - | NPPES |
| 000687409D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 040613 (Georgia) | Primary |
| Provider Name | Bryan D Blake |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316930118 PECOS PAC ID: 6507757150 Enrollment ID: I20040323000644 |
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