Premier Healthcare Alliance | |
2215 Exchange Pl Se Conyers GA 30013-6723 | |
(770) 992-3522 | |
(770) 922-3662 |
Full Name | Premier Healthcare Alliance |
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Speciality | Family Medicine |
Location | 2215 Exchange Pl Se, Conyers, Georgia |
Authorized Official Name and Position | Timothy D Vaughn (VICE PRESIDENT) |
Authorized Official Contact | 6153728505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Premier Healthcare Alliance Po Box 116202 Atlanta GA 30368-6202 Ph: (770) 922-0734 | Premier Healthcare Alliance 2215 Exchange Pl Se Conyers GA 30013-6723 Ph: (770) 992-3522 |
NPI Number | 1326489089 |
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Provider Enumeration Date | 07/10/2013 |
Last Update Date | 07/30/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326489089 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 54898 (Georgia) | Primary |
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