Provider Demographics
NPI:1760223911
Name:OPTIMUM PRIMARY CARE LLC
Entity type:Organization
Organization Name:OPTIMUM PRIMARY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BELLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:404-902-0821
Mailing Address - Street 1:7145 CAVENDER DR SW STE B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-9423
Mailing Address - Country:US
Mailing Address - Phone:404-902-0821
Mailing Address - Fax:855-450-1334
Practice Address - Street 1:7145 CAVENDER DR SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-9423
Practice Address - Country:US
Practice Address - Phone:404-902-0821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care