| Yourtown Health | |
|
202 Croft St Carrollton GA 30117-3803 | |
| (770) 834-2255 | |
| (770) 834-7100 |
| Full Name | Yourtown Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 202 Croft St, Carrollton, Georgia |
| Authorized Official Name and Position | Jon W Wollenzien (CEO) |
| Authorized Official Contact | 4049298824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yourtown Health 643 Main St Palmetto GA 30268-1138 Ph: (404) 929-8824 | Yourtown Health 202 Croft St Carrollton GA 30117-3803 Ph: (770) 834-2255 |
| NPI Number | 1467612952 |
|---|---|
| Provider Enumeration Date | 06/10/2008 |
| Last Update Date | 05/10/2019 |
| Medicare PECOS PAC ID | 3476586629 |
|---|---|
| Medicare Enrollment ID | O20080214000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467612952 | NPI | - | NPPES |
| 000472128G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H800040 (Georgia) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H800040 (Georgia) | Primary |
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