| Saint Joseph's Mercy Care - The Imperial | |
|
355 Peachtree St Ne Atlanta GA 30308-3256 | |
| (404) 410-1420 | |
| Not Available |
| Full Name | Saint Joseph's Mercy Care - The Imperial |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 355 Peachtree St Ne, Atlanta, Georgia |
| Authorized Official Name and Position | E Thomas Andrews (PRESIDENT) |
| Authorized Official Contact | 6788438502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Joseph's Mercy Care - The Imperial 424 Decatur St Se Atlanta GA 30312-1848 Ph: (678) 843-8600 | Saint Joseph's Mercy Care - The Imperial 355 Peachtree St Ne Atlanta GA 30308-3256 Ph: (404) 410-1420 |
| NPI Number | 1689090896 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 09/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689090896 | NPI | - | NPPES |
| 003145199A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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