| Med Strip Llc | |
|
121 Tanglewood N Royston GA 30662-3764 | |
| (706) 726-9612 | |
| Not Available |
| Full Name | Med Strip Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 Tanglewood N, Royston, Georgia |
| Authorized Official Name and Position | Brandi Gordon (CREDENTIALING ORGANIZER) |
| Authorized Official Contact | 7066217561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Strip Llc Po Box 52 Franklin Springs GA 30639-0052 Ph: () - | Med Strip Llc 121 Tanglewood N Royston GA 30662-3764 Ph: (706) 726-9612 |
| NPI Number | 1629476742 |
|---|---|
| Provider Enumeration Date | 12/06/2014 |
| Last Update Date | 12/06/2014 |
| Medicare PECOS PAC ID | 8123347663 |
|---|---|
| Medicare Enrollment ID | O20150505000052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629476742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 48250 (Georgia) | Primary |
| Provider Name | Ashok Kancharla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073603239 PECOS PAC ID: 2567657950 Enrollment ID: I20101111000041 |
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