# PROGRESSIVE COMMUNITY HEALTHCARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407877764
- **Authorized official:** MRS. QUATOYA R TYSON (CLINICAL OFFICE COORDINATOR)
- **Authorized official phone:** (404) 607-1002

## Contact information

- **Practice address:** 494 BOULEVARD SE, ATLANTA, GA 30312-3426
- **Practice address phone:** (404) 607-1002
- **Practice address fax:** (404) 607-1031
- **Mailing address:** PO BOX 54723, ATLANTA, GA 30308
- **Mailing address phone:** (404) 607-1002
- **Mailing address fax:** (404) 607-1031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | GA | — |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 12/13/2011