| Optimal Health Care, Llc | |
|
1121 Johnson Ferry Rd Suite 205 Marietta GA 30068-5425 | |
| (770) 485-3837 | |
| (470) 377-4468 |
| Full Name | Optimal Health Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1121 Johnson Ferry Rd, Marietta, Georgia |
| Authorized Official Name and Position | Sidney Paul Chastang (MANAGER) |
| Authorized Official Contact | 7704853837 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Health Care, Llc 1121 Johnson Ferry Rd Suite 205 Marietta GA 30068-5425 Ph: (770) 485-3837 | Optimal Health Care, Llc 1121 Johnson Ferry Rd Suite 205 Marietta GA 30068-5425 Ph: (770) 485-3837 |
| NPI Number | 1255776134 |
|---|---|
| Provider Enumeration Date | 05/06/2013 |
| Last Update Date | 01/09/2014 |
| Medicare PECOS PAC ID | 7719126556 |
|---|---|
| Medicare Enrollment ID | O20130626000847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255776134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 041094 (Georgia) | Primary |
| Provider Name | Sidney P Chastang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720077225 PECOS PAC ID: 8921021064 Enrollment ID: I20060104000573 |
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