Provider Demographics
NPI:1053706531
Name:GOMED, LLC
Entity type:Organization
Organization Name:GOMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:912-536-3784
Mailing Address - Street 1:2011 COMMERCE DR N
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3538
Mailing Address - Country:US
Mailing Address - Phone:844-994-6633
Mailing Address - Fax:470-235-1861
Practice Address - Street 1:2011 COMMERCE DR N STE 25
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3538
Practice Address - Country:US
Practice Address - Phone:844-994-6633
Practice Address - Fax:770-463-5177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA208D00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11D2139998OtherCLIA WAIVER CERTIFICATION