Healthcare Provider Details

I. General information

NPI: 1336127174
Provider Name (Legal Business Name): APPLE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

772 MADDOX DR SUITE 110
EAST ELLIJAY GA
30540-8194
US

IV. Provider business mailing address

PO BOX 1115
ELLIJAY GA
30540-0014
US

V. Phone/Fax

Practice location:
  • Phone: 706-635-5177
  • Fax: 706-635-5171
Mailing address:
  • Phone: 706-635-5177
  • Fax: 706-635-5171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD B SCHWARTZ
Title or Position: PRESIDENT
Credential: D.O.
Phone: 706-635-5177