Organization
ATLANTA INTEGRATED MEDICAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAMP MATHIS (MANAGER)
(678) 705-8261
Entity
Organization
Contact information
Practice address
626 PARKWAY DR NE, ATLANTA, GA 30308-2614
(678) 705-8261
(678) 705-8361
Mailing address
626 PARKWAY DR NE, ATLANTA, GA 30308-2614
(678) 705-8261
(678) 705-8361
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
159564LGB
GA
305S00000X
Point of Service
159564LGB
GA
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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