| Renew Health Medical Center Llc | |
|
1550 Janmar Rd Ste B Snellville GA 30078-5779 | |
| (770) 822-3031 | |
| (770) 822-3032 |
| Full Name | Renew Health Medical Center Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1550 Janmar Rd Ste B, Snellville, Georgia |
| Authorized Official Name and Position | Pharonda Lee (OWNER) |
| Authorized Official Contact | 7708223031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Health Medical Center Llc 1550 Janmar Rd Ste B Snellville GA 30078-5779 Ph: (770) 822-3031 | Renew Health Medical Center Llc 1550 Janmar Rd Ste B Snellville GA 30078-5779 Ph: (770) 822-3031 |
| NPI Number | 1790238871 |
|---|---|
| Provider Enumeration Date | 07/26/2016 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 4789932484 |
|---|---|
| Medicare Enrollment ID | O20180810002277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790238871 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Georgia) | Secondary |
| 207R00000X | Internal Medicine | (Georgia) | Primary |
| 207VG0400X | Obstetrics & Gynecology - Gynecology | (* (Not Available)) | Secondary |
| Provider Name | Raymond E Easley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255323655 PECOS PAC ID: 7517144504 Enrollment ID: I20110531000110 |
| Provider Name | Tammy L Rivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417379652 PECOS PAC ID: 9739458894 Enrollment ID: I20170705001134 |
| Provider Name | Ayyaz Mahmood Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730114026 PECOS PAC ID: 1456402312 Enrollment ID: I20191205002398 |
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Dr. B Abraham Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3020 Highway 124, Snellville, GA 30039 Phone: 770-978-1331 Fax: 770-978-8580 | |
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