Full Name | |
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Speciality | Clinic/Center |
Location | 4248 Mt. Zion Rd, Mt Zion, Georgia |
Authorized Official Name and Position | Cheryl Toney (CLINIC DIRECTOR) |
Authorized Official Contact | 7708360103 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 658 Mount Zion GA 30150-0658 Ph: (770) 836-0103 | 4248 Mt. Zion Rd Mt Zion GA 30150 Ph: (770) 836-0103 |
NPI Number | 1538117932 |
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Provider Enumeration Date | 05/05/2006 |
Last Update Date | 02/28/2023 |
Medicare PECOS PAC ID | 2264415538 |
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Medicare Enrollment ID | O20101209000668 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538117932 | NPI | - | NPPES |
000228588A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |