| Great Health Medical Ga Pc | |
|
300 Colonial Center Pkwy Ste 100n Roswell GA 30076-4892 | |
| (718) 534-0689 | |
| Not Available |
| Full Name | Great Health Medical Ga Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 Colonial Center Pkwy Ste 100n, Roswell, Georgia |
| Authorized Official Name and Position | Lauren Guse (OWNER) |
| Authorized Official Contact | 6073724270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Health Medical Ga Pc 250 Skillman St Ste 204 Brooklyn NY 11205-1218 Ph: (718) 534-0689 | Great Health Medical Ga Pc 300 Colonial Center Pkwy Ste 100n Roswell GA 30076-4892 Ph: (718) 534-0689 |
| NPI Number | 1881302305 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 02/29/2024 |
| Medicare PECOS PAC ID | 1850761156 |
|---|---|
| Medicare Enrollment ID | O20230106000049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881302305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Korpo Kpissay Erawoc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366970139 PECOS PAC ID: 3476818931 Enrollment ID: I20180604001535 |
| Provider Name | Simone Cherie Nicole Mccray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912494238 PECOS PAC ID: 8325390917 Enrollment ID: I20181009003407 |
| Provider Name | Sarah R. Colson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669734158 PECOS PAC ID: 7315284825 Enrollment ID: I20190122002667 |
| Provider Name | Fenia J Philemond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386135283 PECOS PAC ID: 3476988403 Enrollment ID: I20200121000435 |
| Provider Name | Lauren Guse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770990210 PECOS PAC ID: 8325366990 Enrollment ID: I20220926000505 |
| Provider Name | Aharon Feldman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1235584962 PECOS PAC ID: 8921379249 Enrollment ID: I20230130000666 |
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