Carl Bean Mens Health And Wellness Center | |
2140 M L King Jr Dr Sw 2140 M L King Jr Dr Sw-bldg. B Atlanta GA 30310-1134 | |
(404) 609-3197 | |
(404) 691-8809 |
Full Name | Carl Bean Mens Health And Wellness Center |
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Speciality | Clinic/Center |
Location | 2140 M L King Jr Dr Sw, Atlanta, Georgia |
Authorized Official Name and Position | Rudolph H Carn (PRESIDENT/BOARD CHAIR) |
Authorized Official Contact | 4046600527 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Carl Bean Mens Health And Wellness Center 2140 M L King Jr Dr Sw Bldg. B Atlanta GA 30310-1134 Ph: (404) 660-0527 | Carl Bean Mens Health And Wellness Center 2140 M L King Jr Dr Sw 2140 M L King Jr Dr Sw-bldg. B Atlanta GA 30310-1134 Ph: (404) 609-3197 |
NPI Number | 1134775208 |
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Provider Enumeration Date | 08/14/2019 |
Last Update Date | 06/17/2024 |
Medicare PECOS PAC ID | 8729486998 |
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Medicare Enrollment ID | O20211004000458 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134775208 | NPI | - | NPPES |
123456 | Other | FEE FOR SERVICES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Brandi Pinckney |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407318678 PECOS PAC ID: 8527466796 Enrollment ID: I20211004000556 |
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