| Mend Primary Care Llc | |
|
2256 Northlake Pkwy Ste 204a Tucker GA 30084-4004 | |
| (404) 966-4740 | |
| Not Available |
| Full Name | Mend Primary Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2256 Northlake Pkwy Ste 204a, Tucker, Georgia |
| Authorized Official Name and Position | Tewodros Alemu (PHYSICIAN) |
| Authorized Official Contact | 4049664740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mend Primary Care Llc 8820 Glasgow Pointe Duluth GA 30097-6607 Ph: (404) 966-4740 | Mend Primary Care Llc 2256 Northlake Pkwy Ste 204a Tucker GA 30084-4004 Ph: (404) 966-4740 |
| NPI Number | 1457131526 |
|---|---|
| Provider Enumeration Date | 10/04/2023 |
| Last Update Date | 10/04/2023 |
| Medicare PECOS PAC ID | 6608319801 |
|---|---|
| Medicare Enrollment ID | O20240617000843 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457131526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tewodros Alemu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972039998 PECOS PAC ID: 4284908286 Enrollment ID: I20200804000604 |
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