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Contract Details
Peachtree Occupational Medicine & Urgent Care, LLC
Facility name
Peachtree Occupational Medicine & Urgent Care
Provider ID
P000009149
NPI
1942668363
Tax ID
810824664
Effective Date
5/15/2018
Last Updated
5/16/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_379
AM_379
Location Details
Address
3200 Downwood Peachtree Road NE Suite 700
Atlanta, GA 30327
United States
County
Fulton
Phone
4044251212
(
Phone
)
Billing Details
Address
3200 Downwood Peachtree Road NE
Suite 700
Atlanta, GA 30327
Billing Phone
4044251212
Specialty Type
Urgent Care Facility
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