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General NPI Number Information
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NPI Number | 1568116341
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Entity Type | Organization
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Legal Business Name | ADVANCE CARE MEDICAL GEORGIA, INC.
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 5315 FLYNN CROSSING DR
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City | ALPHARETTA
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State | GA
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Zip | 30005-1796
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Country | US
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Telephone | 866-668-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SCHOOL ST STE 303
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City | GLEN COVE
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State | NY
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Zip | 11542-2548
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Country | US
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Telephone | 866-668-2188
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Fax |
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Authorized Official
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Title or Position | SENIOR ADVISER
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Name | DOUGLAS MILLAR
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Credential |
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Telephone | 917-673-6321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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