Organization
MEDICAL-CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHIDA PATKA (OWNER)
(478) 625-7597
Entity
Organization
Contact information
Practice address
809 PEACHTREE ST, LOUISVILLE, GA 30434-1449
(478) 625-7597
Mailing address
809 PEACHTREE ST, LOUISVILLE, GA 30434-1449
(478) 625-7597
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
11-3948
GA
261QR1300X
Rural Health Clinic/Center
Primary
11-3954
GA
261QR1300X
Rural Health Clinic/Center
11-3965
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000505568D
—
GA
01
—
1164472478
NPI
GA
01
—
1346239639
NPI
GA
01
—
1659431708
NPI
GA
01
—
1821079138
NPI
GA
05
—
191448438A
—
GA
01
—
1962562884
NPI
GA
05
—
415880091A
—
GA
05
—
616207670D
—
GA
05
—
679204194A
—
GA
Enumeration date
01/05/2016
Last updated
04/04/2016
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