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1067 Peachtree St Louisville GA 30434-1558 | |
(478) 625-7000 | |
(478) 625-8907 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1067 Peachtree St, Louisville, Georgia |
Authorized Official Name and Position | Jessica Guy (ASSISTANT ADMINISTRATOR) |
Authorized Official Contact | 4786257000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1067 Peachtree St Louisville GA 30434 Ph: (478) 625-7000 | 1067 Peachtree St Louisville GA 30434-1558 Ph: (478) 625-7000 |
NPI Number | 1215943915 |
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Provider Enumeration Date | 08/01/2006 |
Last Update Date | 09/22/2020 |
Medicare PECOS PAC ID | 7214823046 |
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Medicare Enrollment ID | O20071207000887 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215943915 | NPI | - | NPPES |
000001031B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Medical-care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 Peachtree St, Louisville, GA 30434 Phone: 478-625-7597 | |