| Education System Management, Inc | |
|
125 Highway 138 Riverdale GA 30274 | |
| (770) 742-0265 | |
| (770) 742-0862 |
| Full Name | Education System Management, Inc |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 125 Highway 138, Riverdale, Georgia |
| Authorized Official Name and Position | Carroll Braddy (CEO) |
| Authorized Official Contact | 7708925284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Education System Management, Inc 1115 Mount Zion Rd Suite C Morrow GA 30260-2266 Ph: (770) 742-0265 | Education System Management, Inc 125 Highway 138 Riverdale GA 30274 Ph: (770) 742-0265 |
| NPI Number | 1508134156 |
|---|---|
| Provider Enumeration Date | 12/12/2011 |
| Last Update Date | 01/06/2022 |
| Certification Date | 01/06/2022 |
| Medicare PECOS PAC ID | 1456743830 |
|---|---|
| Medicare Enrollment ID | O20220114000675 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508134156 | NPI | - | NPPES |
| 003148586A | Medicaid | GA | |
| 003168151A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003727 (Georgia) | Secondary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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