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NPI Code Detail

MEDICARE: PRIME COMMUNITY HEALTH GROUP

MEDICARE: PRIME COMMUNITY HEALTH GROUP
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
1111N00000XChiropractor4943GA

General Provider Information

NPI Number : 1164614194
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIME COMMUNITY HEALTH GROUP
Provider Business Mailing Address
First Line : 3435 KINGSBORO RD NE
Second Line : 1804
City : ATLANTA
State : GA
Zip : 30326-1344
Country : US
Telephone Number : 404-505-7500
Fax Number : 404-846-5561
Provider Business Practice Location Address
First Line : 2085 METROPOLITAN PKWY SW
Second Line :
City : ATLANTA
State : GA
Zip : 30315-5926
Country : US
Telephone Number : 404-505-7500
Fax Number : 404-505-1238
Authorized Official
Title or Position : CHIROPRATOR
Name : DR. VERNICE RENEE ROBINSON
Credential : D. C.
Telephone Number : 404-505-7500
Provider Enumeration Date : 08/14/2007
Last Update Date : 12/17/2014

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Directions to “PRIME COMMUNITY HEALTH GROUP ” Practice Location

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