Advance Care Medical PCP Georgia, Inc.
Organization Active NPI Primary Care Clinic/Center · Kennesaw, GA
NPI 1588312946 · NPPES record last updated Mar 15, 2022
Key facts
- NPI
- 1588312946
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- ADVANCE CARE MEDICAL PCP GEORGIA, INC.
- Practice address
- 4300 Bells Ferry Rd NW
Kennesaw, GA 30144-1304 - Phone
- (866) 668-2188
- NPI assigned
- Mar 15, 2022
- Organization subpart
- No
Authorized official
- Name
- Justin Smith
- Title
- Executive Chairman
- Phone
- (866) 668-2188
Corporate family (same tax ID) 4
National Provider Directory
- Tax ID family
- Advance Care Medical PCP Georgia Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
4300 Bells Ferry Rd NW
Kennesaw, GA 30144-1304
Mailing address
3 School St Ste 303
Glen Cove, NY 11542-2548
Phone (866) 668-2188
Other names
- Advance Care Medical Kennesaw GA
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.