MEDICARE: PRIMO HEALTH PARTNERS

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1427791631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMO HEALTH PARTNERS

Provider Business Mailing Address
First Line	:	3635 RIVERS CALL BLVD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-8502
Country	:	US
Telephone Number	:	404-293-0039
Fax Number	:

Provider Business Practice Location Address
First Line	:	3635 RIVERS CALL BLVD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-8502
Country	:	US
Telephone Number	:	404-293-0039
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER AND CHAIRMAN
Name	:	WILLIAM COOPER
Credential	:	MD, MBA, FACC
Telephone Number	:	404-293-0039

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	04/15/2022

Similar Medicare Providers

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Practice Location Address:

3635 RIVERS CALL BLVD
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30339-8502

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1407850001 — DR. JASON JAMES EVERLY PHARM.D., R.PH.
Practice Location Address:

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1811999402 — DR. ELIZABETH G WHITAKER M.D.
Practice Location Address:

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Practice Fax: 770-850-0022

Directions to “PRIMO HEALTH PARTNERS ” Practice Location

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