PIONEER COMMUNITY CARE LLC NPI 1285277566

NPI Information

NPI: 1285277566
Provider Name: PIONEER COMMUNITY CARE LLC

Other Name: PIONEER COMMUNITY CARE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
740 PRINCE AVE STE 8B
ATHENS, GA
ZIP 30606
Phone: (706) 389-5513
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PIONEER COMMUNITY CARE LLC is a primary care clinic center in Athens, GA. PIONEER COMMUNITY CARE LLC NPI is 1285277566. The provider is registered as an organization entity type.
The provider Other Name Is Pioneer Community Care.

The provider's business location address is:

740 PRINCE AVE STE 8B
ATHENS, GA
ZIP 30606-903
Phone: (706) 389-5513

The provider's authorized official is Aynaddis Fekadu .
The authorized official title is Aprn and has the following contact phone number (706) 389-5513.

The CLIA number assigned to this NPI record is 11D2178267 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2019 and was last updated on 1/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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