# PMR GEORGIA HOLDING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PMR GEORGIA HOLDING, LLC
- **Other names:** Jencare Senior Medical Center Forest Park
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164194858
- **Legal business name:** PMR GEORGIA HOLDING, LLC
- **Authorized official:** MARY CHEN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (305) 628-6117

## Contact information

- **Practice address:** 1057 MAIN ST, FOREST PARK, GA 30297-1482
- **Practice address phone:** (404) 301-4555
- **Practice address fax:** (404) 301-4482
- **Mailing address:** 1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
- **Mailing address phone:** (305) 628-6117

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 09/30/2021
- **Last updated:** 09/30/2021