Organization
BRC MEDHEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA R CLARK APRN FNP-BC (NURSE PRACTITIONER)
(770) 231-8568
Entity
Organization
Contact information
Practice address
962 FOREST GLN, JONESBORO, GA 30238-8829
(770) 231-8568
(678) 489-2348
Mailing address
1415 HIGHWAY 85 N STE 108, FAYETTEVILLE, GA 30214-7738
(470) 301-4563
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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