| Aimergency Connect Psychcare | |
|
1775 Parker Rd Se Ste C210 Conyers GA 30094-6676 | |
| (561) 231-2594 | |
| (833) 449-5237 |
| Full Name | Aimergency Connect Psychcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 1775 Parker Rd Se Ste C210, Conyers, Georgia |
| Authorized Official Name and Position | Alexis Daly (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9546866577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aimergency Connect Psychcare Po Box 132 Covington GA 30015-0132 Ph: (954) 686-6577 | Aimergency Connect Psychcare 1775 Parker Rd Se Ste C210 Conyers GA 30094-6676 Ph: (561) 231-2594 |
| NPI Number | 1205519907 |
|---|---|
| Provider Enumeration Date | 08/09/2023 |
| Last Update Date | 04/21/2024 |
| Certification Date | 04/21/2024 |
| Medicare PECOS PAC ID | 3971966300 |
|---|---|
| Medicare Enrollment ID | O20230831003073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205519907 | NPI | - | NPPES |
| Provider Name | Canisha Gillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063981892 PECOS PAC ID: 0446597009 Enrollment ID: I20230414000045 |
| Provider Name | Chinyere Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467954537 PECOS PAC ID: 7719342294 Enrollment ID: I20230505001965 |
| Provider Name | Kisha Nicole Garner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386326981 PECOS PAC ID: 6608210877 Enrollment ID: I20240215001116 |
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