| O.c.h.s. | |
|
1920 Monroe Dr Ne Ste 100 Atlanta GA 30324-4880 | |
| (618) 979-5091 | |
| Not Available |
| Full Name | O.c.h.s. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1920 Monroe Dr Ne Ste 100, Atlanta, Georgia |
| Authorized Official Name and Position | Victoria Grinston (CEO) |
| Authorized Official Contact | 6189795091 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| O.c.h.s. 1920 Monroe Dr Ne Ste 100 Atlanta GA 30324-4880 Ph: (618) 979-5091 | O.c.h.s. 1920 Monroe Dr Ne Ste 100 Atlanta GA 30324-4880 Ph: (618) 979-5091 |
| NPI Number | 1063091262 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 12/28/2023 |
| Medicare PECOS PAC ID | 7113310426 |
|---|---|
| Medicare Enrollment ID | O20220209002185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063091262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | James Rogan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982704300 PECOS PAC ID: 5597740217 Enrollment ID: I20220209002269 |
| Provider Name | Thai-hao Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609296557 PECOS PAC ID: 7618286634 Enrollment ID: I20240222001002 |
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