| Progressive Healthcare & Diagnostics, Llc | |
|
4646 N Shallowford Rd Atlanta GA 30338-6308 | |
| (678) 736-6343 | |
| (678) 990-0940 |
| Full Name | Progressive Healthcare & Diagnostics, Llc |
|---|---|
| Speciality | General Practice |
| Location | 4646 N Shallowford Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Mary Leach (BILLING COLLECTION) |
| Authorized Official Contact | 6787366342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Healthcare & Diagnostics, Llc 303 Perimeter Ctr N Ste 300 Atlanta GA 30346-3401 Ph: (678) 736-6343 | Progressive Healthcare & Diagnostics, Llc 4646 N Shallowford Rd Atlanta GA 30338-6308 Ph: (678) 736-6343 |
| NPI Number | 1295181261 |
|---|---|
| Provider Enumeration Date | 05/10/2016 |
| Last Update Date | 05/10/2016 |
| Medicare PECOS PAC ID | 4284062720 |
|---|---|
| Medicare Enrollment ID | O20200317001696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295181261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Benjamin M Johnston |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952408460 PECOS PAC ID: 0941235246 Enrollment ID: I20051005000278 |
| Provider Name | Deandra D Mcduffie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326311895 PECOS PAC ID: 6204264203 Enrollment ID: I20200324003452 |
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