MEDICARE: CARE DYNAMIX, INC,

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QP0904X	Federal Public Health Clinic/Center
2	207R00000X	Internal Medicine Physician
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1174856397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE DYNAMIX, INC,

Provider Business Mailing Address
First Line	:	235 HEMBREE PARK DR
Second Line	:	SUITE 300
City	:	ROSWELL
State	:	GA
Zip	:	30076-5738
Country	:	US
Telephone Number	:	770-512-8566
Fax Number	:	770-512-8558

Provider Business Practice Location Address
First Line	:	235 HEMBREE PARK DR
Second Line	:	SUITE 300
City	:	ROSWELL
State	:	GA
Zip	:	30076-5738
Country	:	US
Telephone Number	:	770-512-8566
Fax Number	:	770-512-8558

Authorized Official
Title or Position	:	CONTROLLER
Name	:	PAM RILEY
Credential	:
Telephone Number	:	770-512-8566

Provider Enumeration Date	:	09/08/2009
Last Update Date	:	09/03/2010

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