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Radhika Prabhakar

Internal Medicine

Allopathic & Osteopathic Physicians

1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806

PECOS Enrollment

Based on the most recent information from CMS, provider Radhika Prabhakar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1356788772
Provider Type
Individual
Full Name
Prabhakar, Radhika
Gender
Female

Sole Proprietor
No
Enumeration Date
5/24/2013
Last Updated
10/24/2023

Contact Information

Practice Location

1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806

(770) 219-0023

Unlisted Fax

Mailing Location

PO Box 742616, Atlanta, GA 30374-2616

(770) 219-8420

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 97416 Georgia
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License A132696 California

Radhika Prabhakar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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