Pioneer Community Care | |
740 Prince Ave Ste 8b Athens GA 30606-5903 | |
(706) 389-5513 | |
Not Available |
Full Name | Pioneer Community Care |
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Speciality | Clinic/Center |
Location | 740 Prince Ave Ste 8b, Athens, Georgia |
Authorized Official Name and Position | Aynaddis Fekadu (APRN) |
Authorized Official Contact | 7063895513 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pioneer Community Care 740 Prince Ave Ste 8b Athens GA 30606-5903 Ph: (706) 389-5513 | Pioneer Community Care 740 Prince Ave Ste 8b Athens GA 30606-5903 Ph: (706) 389-5513 |
NPI Number | 1285277566 |
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Provider Enumeration Date | 10/19/2019 |
Last Update Date | 01/18/2024 |
Medicare PECOS PAC ID | 4789014192 |
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Medicare Enrollment ID | O20200427002691 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285277566 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Aynaddis Fekadu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114264694 PECOS PAC ID: 0143451609 Enrollment ID: I20160311002098 |
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