Organization
JENCARE NEIGHBORHOOD MEDICAL CENTER WEST END, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CHEN (AUTHORIZED OFFICIAL)
(305) 831-4722
Entity
Organization
Contact information
Practice address
1325 RALPH DAVID ABERNATHY BLVD SW, ATLANTA, GA 30310-1649
(305) 628-6117
Mailing address
1395 NW 167TH ST, MIAMI, FL 33169-5710
(305) 628-6117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
069385
GA
332900000X
Non-Pharmacy Dispensing Site
069385
GA
Other
Enumeration date
03/12/2013
Last updated
10/31/2024
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