MEDICARE: MEDCURA HEALTH, 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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1598468555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCURA HEALTH, INC.

Provider Business Mailing Address
First Line	:	5582 MEMORIAL DR
Second Line	:
City	:	STONE MOUNTAIN
State	:	GA
Zip	:	30083-3215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3065 S COBB DR SE STE A
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-7810
Country	:	US
Telephone Number	:	404-298-8998
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEFF TAYLOR
Credential	:
Telephone Number	:	404-298-3250

Provider Enumeration Date	:	03/27/2023
Last Update Date	:	03/27/2023

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