Individual ProviderAmy KimInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806(770) 219-9675PECOS EnrollmentBased on the most recent information from CMS, provider Amy Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1619418035Provider TypeIndividualFull NameKim, AmyGenderFemaleSole ProprietorNoEnumeration Date3/17/2017Last Updated8/2/2023Contact InformationPractice LocationPractice Address1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806Phone(770) 219-9675FaxUnlisted FaxMailing LocationMailing Address1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense93747Georgia