Healthcare Provider Details
I. General information
NPI: 1841053204
Provider Name (Legal Business Name): MEDCITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2024
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4239 MUNDY MILL RD
OAKWOOD GA
30566-2574
US
IV. Provider business mailing address
PO BOX 920813
PEACHTREE CORNERS GA
30010-0813
US
V. Phone/Fax
- Phone: 678-517-5645
- Fax:
- Phone: 352-617-9649
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MADHAVI
RAYAPUDI
Title or Position: PROVIDER
Credential: MD
Phone: 352-617-9649