MED FAST PC (NPI# 1487849857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487849857 |
| Entity Type | Organization |
| Organization Name | MED FAST PC |
| Practice Address |
902 Athens Hwy Loganville GA 30052-4904 |
| Practice Telephone | 7705545533 |
| Practice Fax Number | 7705548129 |
| Mailing Telephone | 7705545533 |
| Mailing Fax Number | 7705548129 |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-21 |
| Authorized Official Name | ELIZABETH MIKRUT (PRESIDENT) |
| Authorized Official Telephone | 7705545533 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
29730 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GROUP | GRP6328 | 01 |
| Street Address |
902 ATHENS HWY |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-4904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760530778 | Elizabeth Mikrut | Family Medicine | 902 Athens Hwy, Loganville, GA 30052-4904 | 2007-01-08 |
| 1649316464 | Irene Ristic | Family Medicine | 902 Athens Hwy, Loganville, GA 30052-4904 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
| 1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
| 1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
| 1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
| 1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
| 1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
| 1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
| Find all providers in zip 30052 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952097 | Seeley Creek Healthcare | Clinic/Center | E7075 Seeley Creek Rd, Loganville, WI 53943-9670 | 2020-08-15 |
| 1912517921 | Your Care At Home LLC | Clinic/Center | 4132 Atlanta Hwy Ste 110-199, Loganville, GA 30052-5285 | 2020-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942809108 | Lexington Primary Care LLC | Clinic/Center | 777 Athens Rd, Lexington, GA 30648-1902 | 2020-10-20 |
| 1619575834 | The Iv Spot, LLC. | Clinic/Center | 2100 Parklake Dr Ne # C-5, Atlanta, GA 30345-2824 | 2020-10-09 |
| 1528673514 | Safe Haven Medical Services | Clinic/Center | 444 Racetrack Rd, Mcdonough, GA 30252-6837 | 2020-09-15 |
| 1780296533 | North Atlanta Mental Wellness | Clinic/Center | 1742 Mount Vernon Rd Ste 150b, Atlanta, GA 30338-4251 | 2020-08-21 |
| 1639788136 | Walker Health and Wellness LLC | Clinic/Center | 111 Bradford Dr, Bloomingdale, GA 31302-4926 | 2020-07-30 |
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1598389637 | Mercie Health | Clinic/Center | 3721 New Macland Rd Ste 246, Powder Springs, GA 30127-2000 | 2020-06-04 |
| 1366061699 | Beyondmed LLC | Clinic/Center | 1820 Willow Branch Ln Nw, Kennesaw, GA 30152-4558 | 2020-04-16 |
| 1366082596 | Rock Health Inc | Clinic/Center | 5385 Five Forks Trickum Rd Ste F, Stone Mountain, GA 30087-3018 | 2020-01-15 |
| 1477192219 | Meridian Corporate Healthcare of Georgia P C | Clinic/Center | 5163 Thompson Bridge Rd, Murrayville, GA 30564-1930 | 2019-12-26 |
| Find all providers with the same taxonomy | ||||
| City | LOGANVILLE |
| Zip Code | 30052 |
Please comment or provide details below to improve the information on MED FAST PC.
| 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.