MEDICARE: SPECTRUM HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1568396604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECTRUM HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 3505
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-7505
Country	:	US
Telephone Number	:	678-464-3078
Fax Number	:

Provider Business Practice Location Address
First Line	:	2131 PLEASANT HILL RD STE 122
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-4657
Country	:	US
Telephone Number	:	678-464-3078
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHNNY BROWN
Credential	:
Telephone Number	:	678-464-3078

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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