Healthcare Provider Details

I. General information

NPI: 1942105937
Provider Name (Legal Business Name): CARMEN PEARCE RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 NORTHSIDE DR STE 200
MACON GA
31210-2500
US

IV. Provider business mailing address

732 GA HIGHWAY 126
COCHRAN GA
31014-2447
US

V. Phone/Fax

Practice location:
  • Phone: 478-200-3294
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number007324
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: