| Premiercare Omega | |
|
130 Moore St Omega GA 31775-3075 | |
| (229) 528-6500 | |
| (229) 528-3283 |
| Full Name | Premiercare Omega |
|---|---|
| Speciality | Family Medicine |
| Location | 130 Moore St, Omega, Georgia |
| Authorized Official Name and Position | Robert Clyde Bowman (PRESIDENT) |
| Authorized Official Contact | 2293874802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiercare Omega 130 Moore St Omega GA 31775-3075 Ph: (229) 528-6500 | Premiercare Omega 130 Moore St Omega GA 31775-3075 Ph: (229) 528-6500 |
| NPI Number | 1073140927 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 05/05/2020 |
| Medicare PECOS PAC ID | 5395160972 |
|---|---|
| Medicare Enrollment ID | O20200729002807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073140927 | NPI | - | NPPES |
| 256884477 | Other | FAMILY MEDICINE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert C Bowman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518057645 PECOS PAC ID: 2264320654 Enrollment ID: I20040308000790 |
| Provider Name | Jonathan W Tronolone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376626432 PECOS PAC ID: 9537253950 Enrollment ID: I20090507000440 |
| Provider Name | Jeremy W Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952708984 PECOS PAC ID: 1951627744 Enrollment ID: I20150314000164 |
| Provider Name | Kathryn E Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316337090 PECOS PAC ID: 0749508083 Enrollment ID: I20150416000781 |
| Provider Name | Robert C Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518057645 PECOS PAC ID: 2264320654 Enrollment ID: I20200526002067 |
Omega Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 130 Moore St, Omega, GA 31775 Phone: 229-528-6500 |