| Weight Loss And Vitality Center Llc | |
|
360 Racetrack Rd Mcdonough GA 30252-1022 | |
| (404) 902-0821 | |
| Not Available |
| Full Name | Weight Loss And Vitality Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 360 Racetrack Rd, Mcdonough, Georgia |
| Authorized Official Name and Position | Nancy Elizabeth Bellinger (COO) |
| Authorized Official Contact | 1404902082 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Weight Loss And Vitality Center Llc 5686 Fulton Industrial Blvd Sw Unit 43992 Atlanta GA 30336-3216 Ph: (404) 902-0821 | Weight Loss And Vitality Center Llc 360 Racetrack Rd Mcdonough GA 30252-1022 Ph: (404) 902-0821 |
| NPI Number | 1932969334 |
|---|---|
| Provider Enumeration Date | 03/21/2024 |
| Last Update Date | 05/10/2024 |
| Medicare PECOS PAC ID | 0345682233 |
|---|---|
| Medicare Enrollment ID | O20240523001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932969334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
| Provider Name | Darnella Crowder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437834025 PECOS PAC ID: 0244672137 Enrollment ID: I20240523002940 |
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