| Palmetto Health Council Inc | |
|
48 Main St Suite 3a Senoia GA 30276-1895 | |
| (678) 723-0400 | |
| (770) 599-9779 |
| Full Name | Palmetto Health Council Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 48 Main St, Senoia, Georgia |
| Authorized Official Name and Position | Tara Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4049298824 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palmetto Health Council Inc 643 Main St Palmetto GA 30268-1138 Ph: (404) 929-8824 | Palmetto Health Council Inc 48 Main St Suite 3a Senoia GA 30276-1895 Ph: (678) 723-0400 |
| NPI Number | 1235517343 |
|---|---|
| Provider Enumeration Date | 05/08/2015 |
| Last Update Date | 05/14/2025 |
| Medicare PECOS PAC ID | 3476586629 |
|---|---|
| Medicare Enrollment ID | O20150630002532 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235517343 | NPI | - | NPPES |
| 111009 | Other | GA | MEDICARE PIN |
| 003162752A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | H800040 (Georgia) | Primary |