Organization
PEACH STATE HEALTH PLAN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HERBERT SPENCER M.A. (COMPLIANCE OFFICER)
(678) 556-2461
Entity
Organization
Contact information
Practice address
3200 HIGHLANDS PKWY SE, SUITE 300, SMYRNA, GA 30082-5166
(678) 556-2300
(770) 803-0043
Mailing address
3200 HIGHLANDS PKWY SE, SUITE 300, SMYRNA, GA 30082-5166
(678) 556-2300
(770) 803-0043
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
12315
GA
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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