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NPI Code Detail

MEDICARE: THE FAMILY HEALTH CENTERS OF GEORGIA, INC

MEDICARE: THE FAMILY HEALTH CENTERS OF GEORGIA, 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
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760741102
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Provider Business Mailing Address
First Line : 868 YORK AVE SW
Second Line :
City : ATLANTA
State : GA
Zip : 30310-2750
Country : US
Telephone Number : 404-752-1400
Fax Number : 404-756-8749
Provider Business Practice Location Address
First Line : 3700 MARTIN LUTHER KING JR DR SW
Second Line :
City : ATLANTA
State : GA
Zip : 30331-3674
Country : US
Telephone Number : 404-613-6384
Fax Number : 404-893-6856
Authorized Official
Title or Position : PRESIDENT, CEO
Name : MICHAEL W BROOKS
Credential : MD
Telephone Number : 404-752-1400
Provider Enumeration Date : 05/04/2012
Last Update Date : 10/07/2014

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Directions to “THE FAMILY HEALTH CENTERS OF GEORGIA, INC ” Practice Location

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