| Weaver Medical Center, Llc | |
|
195 Martin Luther King Jr Ave Sw Cairo GA 39828-2605 | |
| (229) 397-9262 | |
| Not Available |
| Full Name | Weaver Medical Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 195 Martin Luther King Jr Ave Sw, Cairo, Georgia |
| Authorized Official Name and Position | Mary Weaver (CEO) |
| Authorized Official Contact | 2293979262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Weaver Medical Center, Llc Po Box 1510 Cairo GA 39828-0970 Ph: () - | Weaver Medical Center, Llc 195 Martin Luther King Jr Ave Sw Cairo GA 39828-2605 Ph: (229) 397-9262 |
| NPI Number | 1629531694 |
|---|---|
| Provider Enumeration Date | 04/08/2019 |
| Last Update Date | 04/25/2023 |
| Medicare PECOS PAC ID | 4082032727 |
|---|---|
| Medicare Enrollment ID | O20200914000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629531694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Frances Youmans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073598157 PECOS PAC ID: 6406884790 Enrollment ID: I20050728000478 |
| Provider Name | April Monika Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104441039 PECOS PAC ID: 3072931724 Enrollment ID: I20200914000744 |
| Provider Name | Tamika Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922741396 PECOS PAC ID: 4789061649 Enrollment ID: I20220513001933 |
| Provider Name | Kimberely Dawn Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215416516 PECOS PAC ID: 0143605113 Enrollment ID: I20220913000667 |
The Pediatric Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 980 4th St Se, Cairo, GA 39828 Phone: 229-377-8560 Fax: 229-377-4606 | |
D/b/a Grady Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 235 1st Ave Ne, Cairo, GA 39828 Phone: 229-378-2214 Fax: 833-386-7012 | |
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