Organization
IMMEDIATE CARE CENTERS OF GEORGIA, LLC
Active
Other names
Immediate Care Centers, Tyrone
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY B BENNETT M.D. (DIRECTOR)
(678) 895-0216
Entity
Organization
Contact information
Practice address
190 GREENCASTLE RD., TYRONE, GA 30290
(678) 895-0216
Mailing address
190 GREENCASTLE RD., TRYONE, GA 30290
(678) 895-0216
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
056526
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152797525A
—
GA
Enumeration date
12/24/2007
Last updated
09/09/2008
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