NPI 1013034552

Peach State Health Plan, INC

Organisation Health Maintenance Organization Smyrna, GA

Practice location

Address: 3200 Highlands Pkwy SE Suite 300, Smyrna, GA 30082-5166
Phone: (678) 556-2300
Fax: (770) 803-0043

Authorised official

Name: Herbert Spencer
Title: Compliance Officer
Phone: (678) 556-2461

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 12315 (GA)

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Registry record

NPI: 1013034552
Entity type: Organization
NPI issued: 22 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.