MEDICARE: FRIENDSHIP COMMUNITY HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	81222	GA

General Provider Information

NPI Number	:	1033241666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDSHIP COMMUNITY HEALTHCARE INC

Provider Business Mailing Address
First Line	:	PO BOX 54186
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-0186
Country	:	US
Telephone Number	:	404-607-1002
Fax Number	:	404-697-1031

Provider Business Practice Location Address
First Line	:	430 CENTENNIAL OLYMPIC PARK DR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30313-2203
Country	:	US
Telephone Number	:	404-607-1002
Fax Number	:	404-607-1031

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES EARL CHAMBERS
Credential	:	PA
Telephone Number	:	404-607-1002

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	08/22/2020

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