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General NPI Number Information
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NPI Number | 1760223911
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Entity Type | Organization
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Legal Business Name | OPTIMUM PRIMARY CARE LLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 02/17/2025
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Provider Practice Location Address
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Address Line | 7145 CAVENDER DR SW
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City | ATLANTA
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State | GA
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Zip | 30331-9423
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Country | US
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Telephone | 404-902-0821
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Fax |
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Provider Business Mailing Address
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Address Line | 7145 CAVENDER DR SW STE B
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City | ATLANTA
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State | GA
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Zip | 30331-9423
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Country | US
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Telephone | 404-902-0821
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Fax | 855-450-1334
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Authorized Official
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Title or Position | OWNER
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Name | MS. NANCY ELIZABETH BELLINGER
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Credential | FNP-C
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Telephone | 404-902-0821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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