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NPI Code Detail

MEDICARE: POST ACUTE CARE LEADERS LLC

MEDICARE: POST ACUTE CARE LEADERS LLC
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician
2363L00000XNurse Practitioner
3207QG0300XGeriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1033689336
Entity Type Code : Organization
Provider Name (Legal Business Name) : POST ACUTE CARE LEADERS LLC
Provider Business Mailing Address
First Line : 925 N POINT PKWY STE 425
Second Line :
City : ALPHARETTA
State : GA
Zip : 30005-5200
Country : US
Telephone Number : 678-593-3332
Fax Number : 678-868-1584
Provider Business Practice Location Address
First Line : 156 PINE KNOLL DR
Second Line :
City : CARROLLTON
State : GA
Zip : 30117-2451
Country : US
Telephone Number : 678-593-3332
Fax Number : 678-868-1584
Authorized Official
Title or Position : CONTROLLER
Name : TYLER JUSTISS
Credential :
Telephone Number : 678-593-3332
Provider Enumeration Date : 11/29/2018
Last Update Date : 06/01/2022

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Directions to “POST ACUTE CARE LEADERS LLC ” Practice Location

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