| Vernu 2 | |
|
3333 Old Milton Pkwy Ste 360 Alpharetta GA 30005-4626 | |
| (770) 755-5441 | |
| (770) 203-1072 |
| Full Name | Vernu 2 |
|---|---|
| Speciality | Clinic/Center |
| Location | 3333 Old Milton Pkwy Ste 360, Alpharetta, Georgia |
| Authorized Official Name and Position | Kelly Mccants (OWNER) |
| Authorized Official Contact | 2709453095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vernu 2 3333 Old Milton Pkwy Ste 360 Alpharetta GA 30005-4626 Ph: (770) 755-5441 | Vernu 2 3333 Old Milton Pkwy Ste 360 Alpharetta GA 30005-4626 Ph: (770) 755-5441 |
| NPI Number | 1285242024 |
|---|---|
| Provider Enumeration Date | 07/17/2020 |
| Last Update Date | 02/05/2024 |
| Medicare PECOS PAC ID | 8426469495 |
|---|---|
| Medicare Enrollment ID | O20201123002248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285242024 | NPI | - | NPPES |
| 003151445L | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kelly C Mccants |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689723280 PECOS PAC ID: 4789663840 Enrollment ID: I20141106000607 |
| Provider Name | Kevin Trice |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467548701 PECOS PAC ID: 3476659871 Enrollment ID: I20200224002925 |
| Provider Name | Kimberly Vessels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437534336 PECOS PAC ID: 5698076370 Enrollment ID: I20231031001002 |
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