| Made Whole Healthcare Solutions, Inc | |
|
2709 Gillionville Rd Albany GA 31721-6271 | |
| (229) 483-0020 | |
| (229) 483-0021 |
| Full Name | Made Whole Healthcare Solutions, Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2709 Gillionville Rd, Albany, Georgia |
| Authorized Official Name and Position | Nedra S Fortson (NURSE PRACTITIONER) |
| Authorized Official Contact | 7703308496 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Made Whole Healthcare Solutions, Inc Po Box 71802 Albany GA 31708-1802 Ph: (770) 330-8496 | Made Whole Healthcare Solutions, Inc 2709 Gillionville Rd Albany GA 31721-6271 Ph: (229) 483-0020 |
| NPI Number | 1134519077 |
|---|---|
| Provider Enumeration Date | 01/30/2015 |
| Last Update Date | 07/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134519077 | NPI | - | NPPES |
| 217951 | Medicaid | GA | |
| 20250I9514 | Other | GA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | RN131505 (Georgia) | Primary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
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