| Ejese Healthcare, Pc | |
|
125 Commons Way Ste 203 Villa Rica GA 30180-7041 | |
| (770) 456-6118 | |
| (770) 456-6227 |
| Full Name | Ejese Healthcare, Pc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 125 Commons Way Ste 203, Villa Rica, Georgia |
| Authorized Official Name and Position | James K Irungu (BILLING CONTACT) |
| Authorized Official Contact | 7704566118 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ejese Healthcare, Pc 125 Commons Way Ste 203 Villa Rica GA 30180-7041 Ph: (770) 456-6118 | Ejese Healthcare, Pc 125 Commons Way Ste 203 Villa Rica GA 30180-7041 Ph: (770) 456-6118 |
| NPI Number | 1093800823 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 09/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093800823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 055684 (Georgia) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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