| Pediatric Convenient Care | |
|
1114 Ga Highway 96 Ste D3-d5 Kathleen GA 31047-2111 | |
| (478) 910-1090 | |
| (478) 910-1091 |
| Full Name | Pediatric Convenient Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1114 Ga Highway 96 Ste D3-d5, Kathleen, Georgia |
| Authorized Official Name and Position | Linda Young (EXECUTIVE SECRETARY) |
| Authorized Official Contact | 2292738881 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Convenient Care Po Box 5610 Cordele GA 31010-5610 Ph: (229) 273-8881 | Pediatric Convenient Care 1114 Ga Highway 96 Ste D3-d5 Kathleen GA 31047-2111 Ph: (478) 910-1090 |
| NPI Number | 1447833926 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 05/04/2022 |
| Medicare PECOS PAC ID | 7810980794 |
|---|---|
| Medicare Enrollment ID | O20220421000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447833926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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