Look up the most recent NPI and PECOS records

Primedoc Of Athens Inc

Internal Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Primedoc Of Athens Inc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:58 AM.

Profile Details

Provider ID
1164488623
Provider Type
Organization
Full Name
Primedoc Of Athens Inc

Subpart
No
Enumeration Date
4/25/2006
Last Updated
3/16/2009

Contact Information

Practice Location

1199 Prince Ave, Athens, GA 30606-2797

(843) 237-3378

(843) 237-5073

Mailing Location

PO Box 601153, Charlotte, NC 28260-1153

(843) 237-3378

(843) 237-5073

Authorized Official

Reynolds, Robert (President)

(843) 237-3378

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID DC0899	Description Other	Issuer RAILROAD MEDICARE Georgia
ID 695069922A	Description Medicaid	Issuer Unlisted Georgia

Primedoc Of Athens Inc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Reddy, Malini Kancharla

Athens Area Internal Medicine

Rohrig, Sarah May

Athens Regional Physician Services

Appiah-Pippim, James A

Adelore, Tejumade

Cruz-Vasquez, Danhely

Middendorf, Bruce F

Andre, Tinuola Omoniyi

St. Mary'S Medical Group, Inc.