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General NPI Number Information
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NPI Number | 1588648745
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Entity Type | Organization
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Legal Business Name | AMGP GEORGIA MANAGED CARE COMPANY, INC.
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 303 PERIMETER CTR N SUITE 400
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City | ATLANTA
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State | GA
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Zip | 30346-2402
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Country | US
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Telephone | 678-587-4840
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Fax | 770-604-9330
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Provider Business Mailing Address
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Address Line | 303 PERIMETER CTR N SUITE 400
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City | ATLANTA
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State | GA
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Zip | 30346-2402
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Country | US
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Telephone | 678-587-4840
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Fax | 770-604-9330
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | STEVEN EUGENE MEEKER
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Credential |
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Telephone | 678-587-4840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 2004124
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License Number State | GA
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