| Premier Primary Care Center, Inc | |
|
5820 Old National Hwy College Park GA 30349-3838 | |
| (770) 997-1565 | |
| (770) 997-1568 |
| Full Name | Premier Primary Care Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5820 Old National Hwy, College Park, Georgia |
| Authorized Official Name and Position | Christain C. Ohagwu (CEO) |
| Authorized Official Contact | 4047661970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care Center, Inc 5820 Old National Hwy Suite 250 College Park GA 30349-3838 Ph: (770) 997-1565 | Premier Primary Care Center, Inc 5820 Old National Hwy College Park GA 30349-3838 Ph: (770) 997-1565 |
| NPI Number | 1740311711 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 07/08/2016 |
| Medicare PECOS PAC ID | 0840582763 |
|---|---|
| Medicare Enrollment ID | O20160713000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740311711 | NPI | - | NPPES |
| 300033306A | Medicaid | GA | |
| 10033956 | Other | GA | AMERIGROUP |
| 52624568002 | Other | GA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 039888 (Georgia) | Primary |
| 208000000X | Pediatrics | 039888 (Georgia) | Secondary |
| Provider Name | Christian C Ohagwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083745046 PECOS PAC ID: 9032132717 Enrollment ID: I20060109000609 |
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