| West End Medical Centers, The Family Health Center @ Bolton Village | |
|
2011 Bolton Rd Nw Suite 104 Atlanta GA 30318-1137 | |
| (404) 752-1400 | |
| (404) 756-8749 |
| Full Name | West End Medical Centers, The Family Health Center @ Bolton Village |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2011 Bolton Rd Nw, Atlanta, Georgia |
| Authorized Official Name and Position | Michael W Brooks (CHIEF OPERTAING OFFICER) |
| Authorized Official Contact | 4047521400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West End Medical Centers, The Family Health Center @ Bolton Village 868 York Ave Sw Atlanta GA 30310-2750 Ph: (404) 752-1400 | West End Medical Centers, The Family Health Center @ Bolton Village 2011 Bolton Rd Nw Suite 104 Atlanta GA 30318-1137 Ph: (404) 752-1400 |
| NPI Number | 1225041247 |
|---|---|
| Provider Enumeration Date | 08/14/2006 |
| Last Update Date | 02/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225041247 | NPI | - | NPPES |
| 000437478D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | NON PROFIT EXEMPT (Georgia) | Primary |
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