Kowanda Tenkapowom, is a
Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities based in Augusta, Georgia. Kowanda Tenkapowom is licensed to practice in * (Not Available) (license number ) and her current practice location is
3421 Mike Padgett Hwy, Augusta, Georgia. She can be reached at her office (for appointments etc.) via phone at
(706) 432-7893.
NPI number for Kowanda Tenkapowom is 1316212749 and her current mailing address is 3347 Ravenwood Dr, Augusta, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1316212749.
Healthcare Provider's Profile
| Full Name | Kowanda Tenkapowom |
|---|
| Gender | Female |
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| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
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| Location | 3421 Mike Padgett Hwy, Augusta, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1316212749
- Provider Enumeration Date: 03/19/2012
- Last Update Date: 03/19/2012
Medical Identifiers
Medical identifiers for Kowanda Tenkapowom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316212749 | NPI | - | NPPES |
| 000606317B | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Secondary |
| 320900000X | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kowanda Tenkapowom is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kowanda Tenkapowom,
3347 Ravenwood Dr,
Augusta, GA 30907-3574
Ph: (706) 432-7893 | Kowanda Tenkapowom,
3421 Mike Padgett Hwy,
Augusta, GA 30906-3815
Ph: (706) 432-7893 |
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