Healthcare Provider Details

I. General information

NPI: 1295661098
Provider Name (Legal Business Name): ADVANCE HEALTH INTERNAL MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 E PEACOCK ST STE 3
COCHRAN GA
31014-7846
US

IV. Provider business mailing address

145 E PEACOCK ST STE 3
COCHRAN GA
31014-7846
US

V. Phone/Fax

Practice location:
  • Phone: 478-389-0950
  • Fax: 478-389-0951
Mailing address:
  • Phone: 478-389-0950
  • Fax: 478-389-0951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAN HAMRICK
Title or Position: CFO
Credential:
Phone: 478-448-4435