| Saint Joseph's Mercy Care - Gateway | |
|
275 Pryor St Sw Atlanta GA 30303-3638 | |
| (678) 843-8840 | |
| Not Available |
| Full Name | Saint Joseph's Mercy Care - Gateway |
|---|---|
| Speciality | Clinic/Center |
| Location | 275 Pryor St Sw, Atlanta, Georgia |
| Authorized Official Name and Position | Thomas E. Andrews (PRESIDENT) |
| Authorized Official Contact | 6788438503 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Joseph's Mercy Care - Gateway 424 Decatur St Se Atlanta GA 30312-1848 Ph: (678) 843-8600 | Saint Joseph's Mercy Care - Gateway 275 Pryor St Sw Atlanta GA 30303-3638 Ph: (678) 843-8840 |
| NPI Number | 1821239708 |
|---|---|
| Provider Enumeration Date | 03/23/2009 |
| Last Update Date | 03/24/2009 |
| Medicare PECOS PAC ID | 9931191525 |
|---|---|
| Medicare Enrollment ID | O20141111001374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821239708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Renee Alli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003870874 PECOS PAC ID: 1254622020 Enrollment ID: I20230711003184 |
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