MEDICARE: METRO TREATMENT OF GEORGIA, LP

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	3336C0002X	Clinic Pharmacy	PHOP000002	GA
2	251S00000X	Community/Behavioral Health Agency	NA	GA
3	261QM2800X	Methadone Clinic

General Provider Information

NPI Number	:	1982819595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO TREATMENT OF GEORGIA, LP

Provider Business Mailing Address
First Line	:	2500 MAITLAND CENTER PKWY STE 250
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-4174
Country	:	US
Telephone Number	:	407-351-7080
Fax Number	:	407-351-6930

Provider Business Practice Location Address
First Line	:	2007 OLD LAFAYETTE RD
Second Line	:
City	:	FORT OGLETHORPE
State	:	GA
Zip	:	30742-3510
Country	:	US
Telephone Number	:	706-861-9390
Fax Number	:	407-351-6930

Authorized Official
Title or Position	:	VP, MANAGED CARE
Name	:	SCOTT CALL
Credential	:
Telephone Number	:	480-826-3929

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	05/11/2026

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