| Prime Care Of Georgia Llc | |
|
1000 Towne Center Blvd Ste 604 Pooler GA 31322-4070 | |
| (912) 561-7001 | |
| (912) 561-7002 |
| Full Name | Prime Care Of Georgia Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Towne Center Blvd Ste 604, Pooler, Georgia |
| Authorized Official Name and Position | Shital G Patel (PROVIDER) |
| Authorized Official Contact | 9125617001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Care Of Georgia Llc 1000 Towne Center Blvd Ste 604 Pooler GA 31322-4070 Ph: (912) 561-7001 | Prime Care Of Georgia Llc 1000 Towne Center Blvd Ste 604 Pooler GA 31322-4070 Ph: (912) 561-7001 |
| NPI Number | 1114591096 |
|---|---|
| Provider Enumeration Date | 05/17/2021 |
| Last Update Date | 06/13/2022 |
| Medicare PECOS PAC ID | 3274936901 |
|---|---|
| Medicare Enrollment ID | O20210719002936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114591096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shital Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639498181 PECOS PAC ID: 1759524481 Enrollment ID: I20150928001936 |
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