| Palmetto Health Council Inc | |
|
643 Main St Palmetto GA 30268-1138 | |
| (404) 929-8824 | |
| (404) 929-9769 |
| Full Name | Palmetto Health Council Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 643 Main St, Palmetto, Georgia |
| Authorized Official Name and Position | Jon William Wollenzien (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4049298824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Health Council Inc 643 Main St Palmetto GA 30268-1138 Ph: (404) 929-8824 | Palmetto Health Council Inc 643 Main St Palmetto GA 30268-1138 Ph: (404) 929-8824 |
| NPI Number | 1740372473 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740372473 | NPI | - | NPPES |
| 000228379A | Medicaid | GA | |
| 000472128F | Medicaid | GA | |
| 931512872A | Medicaid | GA | |
| 000472128A | Medicaid | GA | |
| 000472128G | Medicaid | GA | |
| 000472128E | Medicaid | GA | |
| 000472128H | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | H800040 (Georgia) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H800040 (Georgia) | Primary |
Essential Wellness 360, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1281 Mado Loop, Palmetto, GA 30268 Phone: 404-977-2599 | |
Palmetto Health Council Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 643 Main St, Palmetto, GA 30268 Phone: 770-463-4644 Fax: 770-463-9885 | |
The Real Therapists Of Atlanta, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 626 Main St, Palmetto, GA 30268 Phone: 678-898-4941 Fax: 678-818-4619 | |
Palmetto Health Council, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 507 Park St, Palmetto, GA 30268 Phone: 404-929-8824 Fax: 404-929-9769 |