| The Lotus Haven Pc | |
|
950 Dannon Vw Sw Ste 4101 Atlanta GA 30331-2159 | |
| (404) 944-1174 | |
| Not Available |
| Full Name | The Lotus Haven Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 950 Dannon Vw Sw Ste 4101, Atlanta, Georgia |
| Authorized Official Name and Position | Tyronjala Gainey- Grant (CEO) |
| Authorized Official Contact | 4049441174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lotus Haven Pc 425 Dutchview Dr Atlanta GA 30349-7642 Ph: () - | The Lotus Haven Pc 950 Dannon Vw Sw Ste 4101 Atlanta GA 30331-2159 Ph: (404) 944-1174 |
| NPI Number | 1164035564 |
|---|---|
| Provider Enumeration Date | 08/25/2020 |
| Last Update Date | 10/20/2020 |
| Medicare PECOS PAC ID | 4688094980 |
|---|---|
| Medicare Enrollment ID | O20201026000291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164035564 | NPI | - | NPPES |
| Provider Name | Ayjanah Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871908095 PECOS PAC ID: 8628299278 Enrollment ID: I20141023000414 |
| Provider Name | Tyronjala Shontel Gainey-grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659615342 PECOS PAC ID: 5597185892 Enrollment ID: I20201102002049 |
Extreme Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2484 Briarcliff Rd Ne, Suite 22-353, Atlanta, GA 30329 Phone: 678-237-6363 | |
Saint Joseph's Mercy Care - Mary Hall Freedom House Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Hannover Park Rd Ste 100, Atlanta, GA 30350 Phone: 678-843-8500 Fax: 678-843-8601 | |
Physicians Care Centers Of Atlanta, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 285 Boulevard Ne, Suite 435, Atlanta, GA 30312 Phone: 561-385-0731 | |
Tis (to Inspire Strong) African Children Fund, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2233 Peachtree Rd Ne Ste 206a, Atlanta, GA 30309 Phone: 202-872-8333 | |
Comfort Medical Center Phoenix Blvd, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1903 Phoenix Blvd Ste 125, Atlanta, GA 30349 Phone: 404-982-4228 Fax: 404-275-0676 | |
Aylo Health, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3333 Riverwood Pkwy Se Ste 250, Atlanta, GA 30339 Phone: 770-914-0116 Fax: 770-914-7703 | |
Cardiac Disease Specialists, Pc- Sheffield Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1938 Peachtree Rd Nw, Ste 412, Atlanta, GA 30309 Phone: 404-351-3231 Fax: 404-351-3167 |