PALMETTO HEALTH COUNCIL, INC. (NPI# 1235517343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235517343 |
| Entity Type | Organization |
| Organization Name | PALMETTO HEALTH COUNCIL, INC. |
| Other Organization Name | YOURTOWN HEALTH |
| Practice Address |
48 Main St Suite 3a Senoia GA 30276-1895 |
| Mailing Address |
643 Main St Palmetto GA 30268-1138 |
| Practice Telephone | 6787230400 |
| Practice Fax Number | 7705999779 |
| Mailing Telephone | 4049298824 |
| Mailing Fax Number | 4049299769 |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2019-05-10 |
| Authorized Official Name | JON W. WOLLENZIEN JR. (CEO) |
| Authorized Official Telephone | 6789298824 |
| Authorized Official Credential | DBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
H800040 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003162752A | 05 |
| Other Name | Type Code |
|---|---|
| YourTown Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497984769 | Palmetto Health Council, Inc. | Family Medicine | 3939 White House Parkway, Warm Springs, GA 31830-2455 | 2009-07-08 |
| 1952967234 | Palmetto Health Council, Inc. | Clinic/Center | 507 Park St, Palmetto, GA 30268-1007 | 2019-05-13 |
| 1437488426 | Palmetto Health Council, Inc. | Pharmacy | 643 Main St, Palmetto, GA 30268-1138 | 2009-12-22 |
| 1053540328 | Palmetto Health Council, Inc. | Clinic/Center | 51 Gay Connector, Greenville, GA 30222-3339 | 2009-07-08 |
| Street Address |
48 MAIN ST SUITE 3A |
| City | SENOIA |
| State | GA |
| Zip Code | 30276-1895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962863431 | Kim Pogue | Social Worker | 48 Main St, Suite 3a, Senoia, GA 30276-1895 | 2016-03-11 |
| 1457615247 | Marjan Moghaddam | Family Medicine | 48 Main St, Suite 3a, Senoia, GA 30276-1895 | 2012-06-27 |
| 1043356355 | Monica O Watts | Family Medicine | 48 Main St, Suite 3-a, Senoia, GA 30276-1895 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962976563 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 10 Village West Dr. Ste A, Senoia, GA 30276 | 2019-01-16 |
| 1518406842 | Corey Ann Tolbert | Dietitian, Registered | 20 Charleston Dr, Senoia, GA 30276 | 2017-02-20 |
| 1639509920 | Priscilla Jane Thompson | Chore Provider | 229 Deep South Rd, Senoia, GA 30276 | 2013-11-22 |
| 1821331711 | Dana R. Chaffin | Family Medicine | 7285 Highway 16, Suite C, Senoia, GA 30276 | 2013-03-29 |
| 1396747077 | Christina R. Macaluso | Family Medicine | 42 Main Street, Suite 2a, Senoia, GA 30276 | 2005-08-12 |
| 1902236284 | Compassionate Hands Personal Care | Nursing Care | 229 Deep South Rd, Senoia, GA 30276 | 2013-11-22 |
| 1871640920 | Fred Richard Reynolds | Counselor | 252 Seavy Street, Senoia, GA 30276-0147 | 2007-01-04 |
| 1710270996 | Gregory C. Offor | Pharmacist | 120 Renwick Dr, Senoia, GA 30276-1361 | 2011-05-23 |
| 1013445162 | Emily Greene Schubert | Behavioral Analyst | 298 Seavy St, Senoia, GA 30276-1806 | 2017-06-01 |
| 1972830263 | Paraclete Christian Counseling and Educational Services | Community/Behavioral Health | 252 Seavy St, Senoia, GA 30276-1806 | 2009-11-09 |
| Find all providers in zip 30276 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.