| Southern Grace Healthcare | |
|
364 Racetrack Rd Mcdonough GA 30252-1022 | |
| (678) 432-8811 | |
| (678) 432-8821 |
| Full Name | Southern Grace Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 364 Racetrack Rd, Mcdonough, Georgia |
| Authorized Official Name and Position | Aubrey Kekiwi (CEO) |
| Authorized Official Contact | 6784328811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Grace Healthcare 364 Racetrack Rd Mcdonough GA 30252-1022 Ph: (678) 432-8811 | Southern Grace Healthcare 364 Racetrack Rd Mcdonough GA 30252-1022 Ph: (678) 432-8811 |
| NPI Number | 1043609134 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 01/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043609134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 64068 (Georgia) | Primary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Secondary |
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