| Clayton Csb | |
|
1585 Pintail Rd Jonesboro GA 30238-6641 | |
| (770) 478-2280 | |
| Not Available |
| Full Name | Clayton Csb |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 1585 Pintail Rd, Jonesboro, Georgia |
| Authorized Official Name and Position | Terry Cole (CEO) |
| Authorized Official Contact | 7704782280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Csb 112 Broad St Jonesboro GA 30236-3563 Ph: (770) 478-2280 | Clayton Csb 1585 Pintail Rd Jonesboro GA 30238-6641 Ph: (770) 478-2280 |
| NPI Number | 1861700973 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 09/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861700973 | NPI | - | NPPES |
| 00606922AQ | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
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