National Provider Identifier Database

WELLSPRING FAMILY MEDICAL CENTER INC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

WELLSPRING FAMILY MEDICAL CENTER, INC
2759 MOUNT ZION PKWY
SUITE 3
JONESBORO, GA30236-2568
Phone: 678-289-8338
Fax: 770-603-0515
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for WELLSPRING FAMILY MEDICAL CENTER, INC

NPI Number 1538434311
Legal business name
LBN
WELLSPRING FAMILY MEDICAL CENTER, INC
Authorized official OLUBUNMI AYENI - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 03/13/2012
Last updated 03/12/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 43534
  • GA Medicaid: 00794857C
  • GA Medicaid: 00794857D

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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