OrganizationAthens Spine Wellness Center LlcPain MedicineAllopathic & Osteopathic PhysiciansPractice Address830 King Ave, Athens, GA 30606-2889(706) 425-2400PECOS EnrollmentBased on the most recent information from CMS, provider Athens Spine Wellness Center 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 today at 10:05 AM.Profile DetailsProvider ID1306275748Provider TypeOrganizationFull NameAthens Spine Wellness Center LlcSubpartYesEnumeration Date11/6/2013Last Updated11/6/2013Contact InformationPractice LocationPractice Address830 King Ave, Athens, GA 30606-2889Phone(706) 425-2400Fax(706) 425-2410Mailing LocationMailing Address830 King Ave, Athens, GA 30606-2889Phone(706) 425-2400Fax(706) 425-2410Authorized OfficialNameMegdal, William (President)Phone(706) 425-2400Provider TaxonomiesCodeDescriptionLicenseCode208VP0000XPrimaryDescriptionPain MedicineAllopathic & Osteopathic PhysiciansLicense152GeorgiaProvider IdentifiersIDDescriptionIssuerID537122616ADescriptionMedicaidIssuerUnlistedGeorgiaID373133496ADescriptionMedicaidIssuerUnlistedGeorgiaID000275646BDescriptionMedicaidIssuerUnlistedGeorgia