| Eidex Testing Center | |
|
1276 Mcconnell Dr Ste A Decatur GA 30033-3533 | |
| (404) 321-0250 | |
| (404) 321-3535 |
| Full Name | Eidex Testing Center |
|---|---|
| Speciality | Psychologist |
| Location | 1276 Mcconnell Dr Ste A, Decatur, Georgia |
| Authorized Official Name and Position | Rivkah M Eidex (PSYCHOLOGIST) |
| Authorized Official Contact | 4043210250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eidex Testing Center 1276 Mcconnell Dr Ste A Decatur GA 30033-3533 Ph: (404) 321-0250 | Eidex Testing Center 1276 Mcconnell Dr Ste A Decatur GA 30033-3533 Ph: (404) 321-0250 |
| NPI Number | 1447545090 |
|---|---|
| Provider Enumeration Date | 06/12/2011 |
| Last Update Date | 08/04/2011 |
| Medicare PECOS PAC ID | 0941479380 |
|---|---|
| Medicare Enrollment ID | O20110801000867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447545090 | NPI | - | NPPES |
| 000902217A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2499 (Georgia) | Primary |
| Provider Name | Rivkah M Eidex |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760588008 PECOS PAC ID: 1355426073 Enrollment ID: I20080305000444 |
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