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Organization
IMMEDIATE CARE CENTERS OF GEORGIA, LLC
Active
Organization
IMMEDIATE CARE CENTERS OF GEORGIA, LLC
Active
Other names
Immediate Care Centers, Tyrone
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY B BENNETT M.D. (DIRECTOR)
(678) 895-0216
Entity
Organization
Contact information
Practice address
190 GREENCASTLE RD., TYRONE, GA 30290
(678) 895-0216
Mailing address
190 GREENCASTLE RD., TRYONE, GA 30290
(678) 895-0216
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
056526
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152797525A
—
GA
Enumeration date
12/24/2007
Last updated
09/09/2008
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