| Maxx Life Health Care Llc | |
|
1540 Pennsylvania Ave Ste B Mcdonough GA 30253-9112 | |
| (404) 932-7183 | |
| Not Available |
| Full Name | Maxx Life Health Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1540 Pennsylvania Ave Ste B, Mcdonough, Georgia |
| Authorized Official Name and Position | Maria Waller (MANAGING MEMBER) |
| Authorized Official Contact | 4049327183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxx Life Health Care Llc 1540 Pennsylvania Ave Ste B Mcdonough GA 30253-9112 Ph: (404) 932-7183 | Maxx Life Health Care Llc 1540 Pennsylvania Ave Ste B Mcdonough GA 30253-9112 Ph: (404) 932-7183 |
| NPI Number | 1487362919 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 12/22/2023 |
| Medicare PECOS PAC ID | 5890165161 |
|---|---|
| Medicare Enrollment ID | O20221230002040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487362919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
| Provider Name | Betty E Strong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093728404 PECOS PAC ID: 2961430517 Enrollment ID: I20050803001018 |
| Provider Name | Tiffany Regina Smart |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1245945070 PECOS PAC ID: 9739550955 Enrollment ID: I20230126002666 |
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