Your Choice Healthcare PC
Organization Active NPI Family Medicine Physician · Glennville, GA
NPI 1689397200 · NPPES record last updated Sep 20, 2022
Key facts
- NPI
- 1689397200
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- YOUR CHOICE HEALTHCARE PC
- Practice address
- 706 W Barnard St
Glennville, GA 30427-3017 - Phone
- (478) 559-3154
- NPI assigned
- Sep 20, 2022
- Organization subpart
- No
Authorized official
- Name
- Pamela Brown
- Title
- Managing Control
- Phone
- (478) 559-3154
Other NPIs on the same Medicare enrollment 3
Practitioners 1
-
Julie G. Bird, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170619000716 | GA | Part B Supplier - Clinic/Group Practice | 7810265717 |
Receives reassigned benefits from 7 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Baxley, GA; Dublin, GA; Eastman, GA; MC Rae, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
706 W Barnard St
Glennville, GA 30427-3017
Mailing address
706 W Barnard St
Glennville, GA 30427-3017
Other providers in Glennville, GA
All providers in Glennville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2022. 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.