| Lifeline Primary Care, Inc | |
|
4025 Lawrenceville Hwy Nw Ste A Lilburn GA 30047-2876 | |
| (770) 559-3501 | |
| (770) 696-9078 |
| Full Name | Lifeline Primary Care, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4025 Lawrenceville Hwy Nw Ste A, Lilburn, Georgia |
| Authorized Official Name and Position | Aziz A Pirani (OWNER / PHYSICIAN) |
| Authorized Official Contact | 7705593501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Primary Care, Inc 4025 Lawrenceville Hwy Nw Ste A Lilburn GA 30047-2876 Ph: (770) 559-3501 | Lifeline Primary Care, Inc 4025 Lawrenceville Hwy Nw Ste A Lilburn GA 30047-2876 Ph: (770) 559-3501 |
| NPI Number | 1639426984 |
|---|---|
| Provider Enumeration Date | 08/06/2012 |
| Last Update Date | 08/08/2024 |
| Medicare PECOS PAC ID | 3476709304 |
|---|---|
| Medicare Enrollment ID | O20120809000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639426984 | NPI | - | NPPES |
| 1790922096 | Other | GA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 61934 (Georgia) | Primary |
| Provider Name | Aziz Pirani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760622096 PECOS PAC ID: 9032256375 Enrollment ID: I20091020000064 |
| Provider Name | Gayathri Krishna Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790795441 PECOS PAC ID: 4688712730 Enrollment ID: I20170905002150 |
| Provider Name | Dinesh R Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568443273 PECOS PAC ID: 1850294364 Enrollment ID: I20200320001511 |
| Provider Name | Hemakshi Chohan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912505280 PECOS PAC ID: 3274923388 Enrollment ID: I20211203002283 |
| Provider Name | Berly Sojan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609413152 PECOS PAC ID: 3173914108 Enrollment ID: I20211229000802 |
| Provider Name | Vanessa Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760084206 PECOS PAC ID: 7214328269 Enrollment ID: I20211229001896 |
| Provider Name | Jesty Boby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134733199 PECOS PAC ID: 6204227283 Enrollment ID: I20211230000293 |
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