Organization
PEBE MED, INC
Active
Other names
Children First Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROSALITO C CRUZ (CHIEF EXECUTIVE OFFICER)
(706) 231-5977
Entity
Organization
Contact information
Practice address
1267 INTERSTATE PKWY, AUGUSTA, GA 30909-6481
(706) 868-0919
(706) 868-0929
Mailing address
786 LOCKS WAY, MARTINEZ, GA 30907-4976
(706) 231-5977
(706) 868-0929
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
051131
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000940354E
—
GA
Enumeration date
01/10/2011
Last updated
07/21/2022
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