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General NPI Number Information
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NPI Number | 1437309960
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 09/20/2008
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Last Update Date | 09/20/2008
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Provider Practice Location Address
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Address Line | 3644 CHAMBLEE TUCKER RD UNIT B
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City | CHAMBLEE
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State | GA
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Zip | 30341-4405
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Country | US
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Telephone | 404-474-3301
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Fax | 404-474-2705
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Provider Business Mailing Address
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Address Line | 3644 CHAMBLEE TUCKER RD UNIT B
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City | CHAMBLEE
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State | GA
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Zip | 30341-4405
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Country | US
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Telephone | 404-474-3301
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Fax | 404-474-2705
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Authorized Official
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Title or Position | MANAGER
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Name | MARIA DEL PILAR MOREIRA
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Credential |
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Telephone | 404-474-2705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | GA
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