| Eastside Medical Center, Llc | |
|
2160 Fountain Dr Snellville GA 30078-7022 | |
| (770) 985-6473 | |
| (770) 736-3063 |
| Full Name | Eastside Medical Center, Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2160 Fountain Dr, Snellville, Georgia |
| Authorized Official Name and Position | Robert C Cross (VP GOVERNMENT REIMBURSEMENT) |
| Authorized Official Contact | 4702713401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Medical Center, Llc 1700 Medical Way Snellville GA 30078-2195 Ph: (770) 979-0200 | Eastside Medical Center, Llc 2160 Fountain Dr Snellville GA 30078-7022 Ph: (770) 985-6473 |
| NPI Number | 1467406413 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 02/26/2024 |
| Certification Date | 08/17/2023 |
| Medicare PECOS PAC ID | 4183635972 |
|---|---|
| Medicare Enrollment ID | O20070607000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467406413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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