| |
809 Peachtree Street Louisville GA 30434-1449 | |
(478) 625-3743 | |
(478) 625-8361 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 809 Peachtree Street, Louisville, Georgia |
Authorized Official Name and Position | Firoz Patka (PRESIDENT) |
Authorized Official Contact | 4786257597 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
809 Peachtree Street Louisville GA 60434-1449 Ph: (478) 625-7597 | 809 Peachtree Street Louisville GA 30434-1449 Ph: (478) 625-3743 |
NPI Number | 1962562884 |
---|---|
Provider Enumeration Date | 12/11/2006 |
Last Update Date | 11/14/2008 |
Medicare PECOS PAC ID | 8022914829 |
---|---|
Medicare Enrollment ID | O20031211000597 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962562884 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Calin G Badea |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346239639 PECOS PAC ID: 9638119746 Enrollment ID: I20050509000538 |
Provider Name | Praharsha Ravindranatha Menon |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265693543 PECOS PAC ID: 7214194141 Enrollment ID: I20120206000232 |
Medical-care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 Peachtree St, Louisville, GA 30434 Phone: 478-625-7597 | |