| Family Primecare, Llc | |
|
1489 Kennedy Rd Tifton GA 31794-4159 | |
| (229) 391-9931 | |
| (229) 391-9961 |
| Full Name | Family Primecare, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1489 Kennedy Rd, Tifton, Georgia |
| Authorized Official Name and Position | Richard Pierzchajlo (OWNER) |
| Authorized Official Contact | 2293919931 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Primecare, Llc 1489 Kennedy Rd Tifton GA 31794-4159 Ph: (229) 391-9931 | Family Primecare, Llc 1489 Kennedy Rd Tifton GA 31794-4159 Ph: (229) 391-9931 |
| NPI Number | 1811168883 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 03/18/2008 |
| Medicare PECOS PAC ID | 2466648803 |
|---|---|
| Medicare Enrollment ID | O20101124000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811168883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 022620 (Georgia) | Primary |
| Provider Name | Julie R Hooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891850731 PECOS PAC ID: 8820132301 Enrollment ID: I20100222000578 |
| Provider Name | Richard Peter Joseph Pierzchajlo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639175680 PECOS PAC ID: 1759450455 Enrollment ID: I20101124000098 |
| Provider Name | Kayla N Childers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992445480 PECOS PAC ID: 3072991777 Enrollment ID: I20220609000219 |
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Careconnect Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1805 Tift Ave N Ste D, Tifton, GA 31794 Phone: 229-382-5554 Fax: 229-382-0530 | |
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