| Ivydale Wellness Center | |
|
361 Resource Pkwy Winder GA 30680-8364 | |
| (770) 291-0419 | |
| Not Available |
| Full Name | Ivydale Wellness Center |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 361 Resource Pkwy, Winder, Georgia |
| Authorized Official Name and Position | Ablavi Adodo Agomessou (NURSE PRACTITIONER) |
| Authorized Official Contact | 4048198701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivydale Wellness Center 881 Ivydale Ln Lawrenceville GA 30045-7818 Ph: (404) 819-8701 | Ivydale Wellness Center 361 Resource Pkwy Winder GA 30680-8364 Ph: (770) 291-0419 |
| NPI Number | 1659919066 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 10/27/2020 |
| Medicare PECOS PAC ID | 0446688030 |
|---|---|
| Medicare Enrollment ID | O20200313000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659919066 | NPI | - | NPPES |
| Provider Name | Taheerah D Demby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306962436 PECOS PAC ID: 3577707710 Enrollment ID: I20141024001316 |
| Provider Name | Ablavi A Agomessou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164885778 PECOS PAC ID: 4385926112 Enrollment ID: I20170131000635 |
| Provider Name | Benedicta N Okoye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922453117 PECOS PAC ID: 3577852904 Enrollment ID: I20180713000021 |
Medlink Winder Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 133 W Athens St, Winder, GA 30680 Phone: 770-867-6633 | |
Barrow County Health Department Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15 Porter Street East, Winder, GA 30680 Phone: 770-307-3011 Fax: 770-307-1039 | |
Pulmonary And Sleep Medicine Center Of Winder Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 30 Satellite Dr, Suite 200, Winder, GA 30680 Phone: 770-586-0300 Fax: 770-586-0311 | |
Winder Internal Medicine And Geriatrics Center Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 30 Satellite Dr, Suite 100, Winder, GA 30680 Phone: 770-586-0310 Fax: 770-586-0312 | |
William T. Mac New, Jr. Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 N Broad St, Suite 250, Winder, GA 30680 Phone: 770-867-4146 | |
Medlink Georgia, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 125 W Athens St, Winder, GA 30680 Phone: 706-867-6633 | |
Winder Adult Primary Care & Wellness, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 N Broad St, Suite 350, Winder, GA 30680 Phone: 770-867-0455 Fax: 770-867-3990 |