Hormone and Diabetic Infusion Center
Organization Active NPI Infusion Therapy Clinic/Center · Eatonton, GA
NPI 1154042265 · NPPES record last updated Feb 21, 2023
Key facts
- NPI
- 1154042265
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infusion Therapy Clinic/Center 261QI0500X
- Legal business name
- HORMONE AND DIABETIC INFUSION CENTER
- Practice address
- 1129 Lake Oconee Pkwy Ste 104
Eatonton, GA 31024-9581 - Phone
- (762) 220-1962
- Fax
- (762) 220-1961
- NPI assigned
- Sep 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Jessica Marie Alferink, FNP-C
- Title
- Owner
- Phone
- (762) 220-1962
Practitioners 7
-
Sharelle Farley, FNP-BC
-
Errol G Graham, M.D.
-
Natasha L Osborne, NP-C
-
Aaron Butch Ward, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230227000069 | GA | Part B Supplier - Clinic/Group Practice | 2961875760 |
Receives reassigned benefits from 7 practitioners Practice locations: Eatonton, GA |
National Provider Directory
Locations
1129 Lake Oconee Pkwy
Ste 104
Eatonton, GA 31024
Phone (706) 485-4004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Infusion Therapy Clinic/Center | 261QI0500X | Yes |
Addresses
Primary practice location
1129 Lake Oconee Pkwy Ste 104
Eatonton, GA 31024-9581
Mailing address
1129 Lake Oconee Pkwy Ste 104
Eatonton, GA 31024-9581
Phone (762) 220-1962
Other providers in Eatonton, GA
- Brayden Dunn Hill
- Kimberly Ann Hoffman
- Shanna Barbara Holcomb
- Michele A Holstad
- Diana Cafaro Homeier
- Ronald Huet
- Valerie Hurt
- Cassandra Lynn Hyde
- Zoe Madison Irvin
- Kene James
All providers in Eatonton, GA · Infusion Therapy Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.