| Saint Joseph's Mercy Care Services Inc | |
|
424 Decatur St Se Atlanta GA 30312-1848 | |
| (404) 880-3550 | |
| (404) 880-3578 |
| Full Name | Saint Joseph's Mercy Care Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 424 Decatur St Se, Atlanta, Georgia |
| Authorized Official Name and Position | E Thomas Andrews (PRESIDENT) |
| Authorized Official Contact | 4048803559 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Joseph's Mercy Care Services Inc 424 Decatur St Se Atlanta GA 30312-1848 Ph: (404) 880-3550 | Saint Joseph's Mercy Care Services Inc 424 Decatur St Se Atlanta GA 30312-1848 Ph: (404) 880-3550 |
| NPI Number | 1831266618 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 04/16/2008 |
| Medicare PECOS PAC ID | 9931191525 |
|---|---|
| Medicare Enrollment ID | O20040401001771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831266618 | NPI | - | NPPES |
| 00649844A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | NOT REQUIRED (Georgia) | 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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