| Premium Care Med Group Inc | |
|
3828 Salem Rd Suite 200 Covington GA 30016-4528 | |
| (404) 422-8719 | |
| Not Available |
| Full Name | Premium Care Med Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3828 Salem Rd, Covington, Georgia |
| Authorized Official Name and Position | Ted M Pennel (CEO) |
| Authorized Official Contact | 4044228719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Care Med Group Inc 3828 Salem Rd Suite 200 Covington GA 30016-4528 Ph: () - | Premium Care Med Group Inc 3828 Salem Rd Suite 200 Covington GA 30016-4528 Ph: (404) 422-8719 |
| NPI Number | 1295965986 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 07/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295965986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 029068 (Georgia) | Primary |
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