Basic Information
| Provider Information | |||||||||
| NPI: | 1619274180 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAGEMED, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE ST NE | ||||||||
| Address2: | SUITE 1275 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048723121 | ||||||||
| FaxNumber: | 4048723119 | ||||||||
| Practice Location | |||||||||
| Address1: | 380 HOSPITAL DR BLDG SUITE460 | ||||||||
| Address2: | |||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312178001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4782165233 | ||||||||
| FaxNumber: | 4044197031 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2011 | ||||||||
| LastUpdateDate: | 09/15/2020 | ||||||||
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| AuthorizedOfficialLastName: | CULVER | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4048723121 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.