OrganizationLiveon One, Llc(Liveon Medical Center)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address80 Vinings Dr, Mcdonough, GA 30253-5994(770) 302-6780PECOS EnrollmentBased on the most recent information from CMS, provider Liveon One, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1265770515Provider TypeOrganizationFull NameLiveon One, LlcOther NameLiveon Medical CenterSubpartNoEnumeration Date1/22/2013Last Updated3/13/2019Contact InformationPractice LocationPractice Address80 Vinings Dr, Mcdonough, GA 30253-5994Phone(770) 302-6780Fax(678) 782-3776Mailing LocationMailing Address80 Vinings Dr, Mcdonough, GA 30253-5994Phone(770) 302-6780Fax(678) 782-3776Authorized OfficialNameFletcher, Ernie (Ceo/Physician)Phone(770) 302-6780Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense64538GeorgiaProvider IdentifiersIDDescriptionIssuerID003201616ADescriptionMedicaidIssuerUnlistedGeorgiaID202G708497DescriptionOtherIssuerMEDICAREGeorgia