Provider Directory 2008 Coventry Health Care. All rights reserved.

Transcription

1 Provider Directory

2 Provider Directory Table of Contents UNDERSTANDING YOUR HEALTH PLAN...2 SERVICE AREA MAP...3 PARTICIPATING HOSPITALS...4 URGENT CARE CENTERS...6 CONVENIENCE CARE CLINICS...8 ANCILLARY PROVIDERS...9 PROVIDERS...35 CHIROPRACTIC PROVIDERS ROUTI VISION PROVIDERS PARTICIPATING PHARMACIES MENTAL HEALTH/SUBSTANCE ABUSE PROVIDER INDEX...230

3 CHOOSING YOUR PRIMARY CARE PHYSICIAN Your Primary Care Physician (PCP) acts as your personal physician coordinating all of your health care needs. Our plans are Open Access, which means you can self-refer to an in-network PCP or specialist. You can all have the same doctor or different ones - it s your choice! Chances are, your family doctor is participating with Coventry Health Care of Georgia, Inc. If you do not see your Provider listed in this Directory, please refer to our website at for the most current listing. WHAT IF I ED TO SEE A SPECIALIST? Again, our plans are Open Access and do not require a referral to see an in-network specialist. However, we recommend keeping your PCP informed whenever you seek care from other providers even if a referral is not required. WHAT IF I ED HOSPITAL CARE? Your participating physician and admitting facility are responsible for obtaining authorization from Coventry Health Care and arranging hospital care for you. Before an elective admission, it is your responsibility to ensure that you are receiving covered services and the authorization has been obtained. To confirm your authorization, please contact Customer Service at the number listed on the back of your member ID card. Please be aware that your financial responsibility will depend upon the participation status of the facility. WHAT SHOULD I DO IN AN EMERGENCY? As a member, you are covered for medical emergencies that occur when you are in or out of our service area. A medical emergency is any medical condition that would cause a prudent person, having average medical knowledge, to believe that a failure to obtain immediate medical help would place their health in serious jeopardy or result in a serious impairment or dysfunction of bodily functions, organs or parts. In a medical emergency, go to the nearest emergency room, or dial 911 for treatment. We recommend following up with your PCP after receiving emergency services. (To receive benefits, follow-up care should be coordinated within the Coventry network.) CONVENIENCE CARE AND URGENT CARE Some illnesses and injuries do not require an emergency room visit. Before seeking treatment for conditions like sprains, sore throat, cold, flu, minor cuts, rashes, or stomach problems, call your doctor first to find out whether a trip to an emergency room is necessary or if you could be treated at the doctor s office, local convenience care clinic or urgent care center. Refer to Page 8 in the Directory for network Convenient Care Clinics and refer to Page 6 for a list of network Urgent Care Centers. DO I ED MY IDENTIFICATION CARD? To receive full benefits, you must show your member identification card at the time you receive medical services. This will help avoid confusion and billing problems. Also, when you make an appointment, be sure to identify yourself as a Coventry Health Care of Georgia member. WHEN DO I PAY MY COPAYMENT/ COINSURANCE/ DEDUCTIBLE? Please pay your copayment at the provider s office when you receive medical care. Your provider may choose to collect some or all of your coinsurance or deductible payments at the time of service. QUESTIONS? Customer Service is available to assist you whenever you have a question about our network of providers or your benefits. Please note that providers have been added or deleted since this directory was printed. For the most current listing, please visit our website at You may also call Customer Service at the phone number listed on your member ID card. Representatives are available to answer your questions, Monday Friday, from 7 a.m. 6 p.m. 2

4 Marketing Area Heard Floyd Haralson Polk Bartow Cherokee Dawson White Paulding Cobb Douglas Coweta Fulton Spalding Henry Newton Morgan Walton Barrow Jackson Banks Hall Gwinnett Dekalb Clayton Rockdale Fayette Forsyth Oconee Clarke Madison Oglethorpe Bulloch Effingham Chatham Bryan Liberty Lumpkin Gordon Pickens Gilmer Carroll Butts Jasper Monroe Lamar Jones Bibb Crawford Peach Houston Twiggs Wilkinson Bleckley Columbia Richmond Screven Evans Long Appling Brantley Pierce Ware Atkinson Chattooga Emanuel Candler Greene Wayne Toombs Montgomery Treutlen Habersham Meriwether Pike Taylor Macon Dooly McDuffie Burke Tattnall CHC_

5 Participating Hospitals AIKEN COUNTY, SC Aiken Regional Medical Centers 302 University Pkwy Aiken, SC (803) APPLING COUNTY, Appling Healthcare System 163 E Tollison St Baxley, (912) BUTTS COUNTY, Sylvan Grove Hospital 1050 McDonough Rd Jackson, (770) CANDLER COUNTY, Candler County Hospital 400 Cedar St Metter, (912) CLAYTON COUNTY, Southern Crescent Hospital for Specialty Care 11 Upper Riverdale Rd SW 6th Floor (770) Southern Regional Medical Center 11 Upper Riverdale Rd SW (770) Emory University Hospital 1364 Clifton Rd (404) DODGE COUNTY, Dodge County Hospital 901 Griffin Ave Eastman, (478) DOUGLAS COUNTY, The Specialty Hospital 304 Turner McCall Blvd SW (706) FORSYTH COUNTY, Northside Hospital Forsyth 1200 Baptist Medical Center Dr (770) FULTON COUNTY, BARROW COUNTY, Barrow Community Hospital 316 N Broad St Winder, (770) BARTOW COUNTY, Cartersville Medical Center 960 Joe Frank Harris Pkwy SE P.O. Box Cartersville, (770) BIBB COUNTY, Medical Center of Central Georgia (478) BLECKLEY COUNTY, Bleckley Memorial Hospital 145 E Peacock St Cochran, (912) BULLOCH COUNTY, East Georgia Regional Med Ctr 1499 Fair Rd Statesboro, (912) BURKE COUNTY, Burke Medical Center 351 S Liberty St Waynesboro, (706) CARROLL COUNTY, Tanner Medical Center 705 Dixie St Carrollton, (770) Tanner Medical Ctr-Villa Rica 601 Dallas Hwy Villa Rica, (770) CHATHAM COUNTY, Candler Hospital 5353 Reynolds St (912) Sempercare Hospital of Savannah, Inc Reynolds St (912) St. Joseph's/Candler Hlth Syst Mercy Blvd Savannah, (912) CHEROKEE COUNTY, Northside Hospital - Cherokee 201 Hospital Rd Canton, (770) CLARKE COUNTY, St. Mary's Health Care System 1230 Baxter St (706) COBB COUNTY, Emory-Adventist Hospital 3949 S Cobb Dr SE Smyrna, (770) WellStar Cobb Hospital 3950 Austell Rd (770) WellStar Kennestone Hospital 677 Church St (770) WellStar Windy Hill Hospital 2540 Windy Hill Rd SE Marietta, (770) COWETA COUNTY, Newnan Hospital-West 60 Hospital Rd Newnan, (770) DE KALB COUNTY, Children's Healthcare of Atlanta at Egleston 1405 Clifton Rd (404) Decatur Hospital 450 N Candler St Decatur, (404) DeKalb Medical Center 2701 N Decatur Rd (404) DeKalb Medical Center - Hillandale 2801 Dekalb Medical Pkwy Lithonia, (404) WellStar Douglas Hospital 8954 Hospital Dr Frnt (770) EFFINGHAM COUNTY, Effingham Hospital 459 Ga Highway 119 S Springfield, (912) EMANUEL COUNTY, Emanuel County Hospital 117 Kite Rd Swainsboro, (478) EVANS COUNTY, Evans Memorial Hospital 200 N River St Claxton, (912) FAYETTE COUNTY, Piedmont Fayette Hospital 1255 Hwy 54, W (770) FLOYD COUNTY, Floyd Medical Center 304 Turner McCall Blvd SW (706) Redmond Regional Medical Ctr 501 Redmond Rd NW (706) Atlanta Medical Center 303 Parkway Dr Atlanta, (404) Children's Healthcare Atlanta 1001 Johnson Ferry Rd (404) Crawford Long Hosp Emory Univ 550 Peachtree St (404) Emory Johns Creek Hospital 6325 W Johns Xing Duluth, (678) Grady Memorial Hospital 80 Butler Street SE Hughes Spalding Children's Hospital 35 Jesse Hill Jr Dr SE (404) North Fulton Regional Hospital 3000 Hospital Blvd (770) Northside Hospital 1000 Johnson Ferry Rd (404) Piedmont Hospital 1968 Peachtree Rd NW (404) Saint Joseph's Hosp of Atlanta 5665 Peachtree Dunwoody Rd (404) Shepherd Center 2020 Peachtree Rd NW (404)

6 Participating Hospitals Participating Hospitals South Fulton Medical Center 1170 Cleveland Ave Atlanta, (404) GILMER COUNTY, North Georgia Medical Center 1362 S Main St Ellijay, (706) GORDON COUNTY, Gordon Hospital 1035 Red Bud Rd Calhoun, (706) GREE COUNTY, Minnie G Boswell Mem Hospital 1201 Siloam Rd Greensboro, (706) GWINTT COUNTY, Emory Eastside Medical Center 1700 Medical Way (770) Gwinnett Hospital System 1000 Medical Center Blvd (770) Joan Glancy Memorial Hospital 3215 McClure Bridge Rd Duluth, (678) HALL COUNTY, Northeast Georgia Medical Center-Lanier Park Campus 675 White Sulphur Rd (678) Northeast Georgia Medical Ctr 743 Spring St (770) HARALSON COUNTY, TMC/Higgins General Hospital 200 Allen Memorial Dr Bremen, (770) HENRY COUNTY, Henry Medical Center 1133 Eagles Landing Pkwy (678) HOUSTON COUNTY, Houston Medical Center 1601 Watson Blvd Warner Robins, (912) Perry Hospital 1120 Morningside Dr Perry, (478) JACKSON COUNTY, BJC Medical Center 70 Medical Center Dr Commerce, (706) JASPER COUNTY, Jasper Memorial Hospital 898 College St Monticello, (706) LIBERTY COUNTY, Liberty Regional Medical Ctr 462 E G Parkway Hinesville, (912) LOWNDES COUNTY, South Georgia Medical Center 2501 N Patterson St Valdosta, (229) LUMPKIN COUNTY, Chestatee Regional Hospital 227 Mountain Dr Dahlonega, (706) MCDUFFIE COUNTY, McDuffie Regional Medical Ctr 521 W Hill St Thomson, (706) MERIWETHER COUNTY, Warm Springs Medical Center 5995 Spring St Warm Springs, (706) MONROE COUNTY, Monroe County Hospital 88 Martin Luther King Jr Dr Forsyth, (912) MORN COUNTY, Morgan Memorial Hospital Canterbury Park Madison, (706) MUSCOGEE COUNTY, The Medical Center 710 Center St Columbus, (706) WTON COUNTY, Newton Medical Center 5126 Hospital Dr Covington, (770) PAULDING COUNTY, WellStar Paulding Hospital 600 W Memorial Dr Dallas, (770) PEACH COUNTY, Peach Regional Medical Center 601 N Camellia Blvd Fort Valley, (478) PICKENS COUNTY, Mountainside Medical Center 1266 Highway 515 S Jasper, (706) POLK COUNTY, Polk Medical Center 424 N Main St Cedartown, (770) RICHMOND COUNTY, Doctors Hospital 3651 Wheeler Rd Augusta, (706) Medical Clg of Georgia Hosp (706) St. Joseph Hospital 2260 Wrightsboro Rd Augusta, (706) University Health Care System 1350 Walton Way (706) ROCKDALE COUNTY, Rockdale Hospital & Hlth Syst 1412 Milstead Ave Conyers, (770) SCREVEN COUNTY, Screven County Hospital 215 Mims Rd Sylvania, (912) SPALDING COUNTY, Spalding Regional Hospital 601 S 8th St Griffin, (770) TATTNALL COUNTY, Tattnall Memorial Hospital Route 1 Reidsville, (912) TOOMBS COUNTY, Meadows Regional Medical Ctr 1703 Meadows Ln Vidalia, (912) WALTON COUNTY, Walton Medical Center 330 Alcovy St Monroe, (770) WARE COUNTY, Satilla Regional Medical Ctr 410 Darling Ave Waycross, (912) WAY COUNTY, Wayne Memorial Hospital 865 S 1st St Jesup, (912)

7 Urgent Care Centers BIBB COUNTY, Med Center - East 1339 Gray Hwy Macon, (478) Med Center - North 3400 Riverside Dr Macon, (478) Med Center - West 711 Eisenhower Pkwy Macon, (478) Med Center-Northwest 5925 Zebulon Rd Macon, (478) Pediatrics After Hours 3400 Riverside Dr Macon, (706) CHATHAM COUNTY, Concentra Urgent Care 109 Minis Ave Suite C-10 Savannah, (912) Georgia Emergency Associates Immediate Care Center 361 Commercial Dr Savannah, (912) CHATTOO COUNTY, Floyd Urgent Care Highway 27 Summerville, (706) CHEROKEE COUNTY, Immediate MedCare of Woodstock Highway 92 0 Woodstock, (770) Physicians' Immediate Med of Canton PC 720 Transit Ave Canton, (770) WellStar Urgent Care at Towne Lake, LLC 120 Stonebridge Pkwy (678) CLAYTON COUNTY, Children's Healthcare of Atlanta at Mount Zion 2201 Mount Zion Pkwy Morrow, (404) COBB COUNTY, Children's Healthcare of Atlanta at Town Center 2985 George Busbee Pkwy NW Kennesaw, (404) Concentra Urgent Care 220 Cobb Pkwy N Ste 400 Marietta, (770) Physicians' Immediate Med 2481 George Busbee Pky Kennesaw, (770) WellStar Urgent Care in Kennesaw, LLC 3805 Cherokee St NW Kennesaw, (770) WellStar Urgent Care on Delk Road, LLC 2890 Delk Rd SE Marietta, (770) WellStar Urgent Care on Sandy Plains Road, LLC 3600 Sandy Plains Rd Marietta, (770) COLUMBIA COUNTY, University Hospital Prompt Care Columbia County 447 N Belair Rd Evans, (706) COWETA COUNTY, Summit Healthplex 1755 Highway 34 E Newnan, (770) DAWSON COUNTY, Physicians' Immediate Med of Dawsonville, P.C. 91 Nordson Overlook Dawsonville, (706) DE KALB COUNTY, Community Care, PC 5019 Lavista Rd Tucker, (404) Emory Student Health Center 2711 Irvin Way Suite 111 Decatur, (404) Hillandale Minor Emergency Center 5910 Hillandale Dr Suite 103 Lithonia, (770) ICCS dba Toco Hills Urgent Care 3019 N Druid Hills Rd Atlanta, (404) New Peachtree Rd Atlanta, (404) DOUGLAS COUNTY, Physicians' Immediate Med of Douglasville PC 9390 The Landing Dr Douglasville, (770) TMC Immediate Care, Inc Highway 5 Ste E (770) EFFINGHAM COUNTY, Effingham Hospital MedCare 100 Goshen Rd Rincon, (912) FLOYD COUNTY, Floyd Urgent Care 304 Shorter Ave NW (706) FULTON COUNTY, Children's Healthcare of Atlanta at North Point 3795 Mansell Rd Alpharetta, (404) Concentra Urgent Care 3580 Atlanta Ave Atlanta, (404) Physicians' Immediate Med Haynes Bridge Rd Alpharetta, (770) U.S. Healthworks Medical Group of Georgia, PC 900 Holcomb Bridge Rd (770) GWINTT COUNTY, Children's Healthcare of Atlanta at Satellite Blvd 2660 Satellite Blvd Duluth, (404) Concentra Urgent Care 1905 Beaver Ruin Rd Ste 175 Norcross, (770) Physicians' Immediate Med 3551 Satellite Blvd Duluth, (770) Holcomb Bridge Rd Norcross, (770) Physicians' Immediate Med of Buford, P.C Buford Dr Buford, (678) Premier Immediate Care of Georgia, PC 2696 Lawrenceville Suwanee Rd (678) Grayson Hwy (678) HALL COUNTY, Guilford Immediate Care 1250 Jesse Jewell Pkwy SE Suite 400 (770) Urgent Care Friendship 4889 Golden Pkwy Buford, (678) HENRY COUNTY, Brightpoint Urgent Care, LLC 1365 Rock Quarry Rd (770) Minor Emergency Care 101 Regency Park Dr Mcdonough, (770) Spalding Regional Urgent Care Center at Heron Bay L.L.C Highway 155 Locust Grove, (678) HOUSTON COUNTY, Houston Lake Med- Stop 2510 Hwy 127 Kathleen, (478) Pavillion Med-Stop 233 N Houston Rd Warner Robins, (478)

8 Urgent Care Centers Polk LOWNDES COUNTY, Convenient Care - Valdosta 2330 N Ashley St Valdosta, (229) MUSCOGEE COUNTY, Regional Urgent Care th Ave Ste F Columbus, (706) PAULDING COUNTY, Physicians' Immediate Med of Hiram PC 3827 Jimmy Lee Smith Pkwy Hiram, (770) POLK COUNTY, Floyd Urgent Care 1025 N Main St Cedartown, (770)

9 Convenience Care Clinics CHEROKEE COUNTY, MinuteClinic Diagnostic of Georgia, LLC 1600 Towne Lake Pkwy (866) Sixes Rd Canton, (866) Hickory Flat Hwy Canton, (866) COBB COUNTY, MinuteClinic Diagnostic of Georgia, LLC 2014 Powers Ferry Rd SE Atlanta, (866) Atlanta Rd SE Smyrna, (866) N Main St NW Kennesaw, (866) Due West Rd NW Marietta, (866) Paces Ferry Rd SE Atlanta, (866) Take Care Health Georgia, PC 1762 Mars Hill Rd NW Acworth, (866) Roswell Rd Marietta, (866) Cobb Pkwy NW Kennesaw, (866) Shallowford Rd Marietta, (866) Austell Rd (866) Take Care Health Georiga, PC 2670 Cobb Pkwy SE Smyrna, (866) COWETA COUNTY, MinuteClinic Diagnostic of Georgia, LLC 2305 Highway 34 E Newnan, (866) DE KALB COUNTY, MinuteClinic Diagnostic of Georgia, LLC 2738 N Decatur Rd (866) Peachtree Industrial Blvd Atlanta, (866) Rockbridge Rd Stone Mountain, (866) Take Care Health Georgia, PC 5230 Memorial Dr Stone Mountain, (866) Take Care Health Georiga, PC 2945 Panola Rd Lithonia, (866) DOUGLAS COUNTY, MinuteClinic Diagnostic of Georgia, LLC 6031 Fairburn Rd (866) Take Care Health Georgia, PC 9465 Highway 5 Douglasville, (866) FAYETTE COUNTY, MinuteClinic Diagnostic of Georgia, LLC 100 Carriage Oaks Dr Tyrone, (866) Lexington Cir Peachtree City, (866) FORSYTH COUNTY, MinuteClinic Diagnostic of Georgia, LLC 5370 Laurel Springs Pkwy (866) FULTON COUNTY, MinuteClinic Diagnostic of Georgia, LLC 1380 Woodstock Rd Roswell, (866) Martin Luther King Jr Dr SW Atlanta, (866) Powers Ferry Rd NW Atlanta, (866) Old National Hwy Riverdale, (866) N Highland Ave Atlanta, (866) Holcomb Bridge Rd (866) MinuteClinic Diagnostic of Gerogia, LLC Alpharetta Hwy (866) Take Care Health Georgia, PC 3003 Old Alabama Rd Alpharetta, (866) Roswell Rd Atlanta, (866) GWINTT COUNTY, MinuteClinic Diagnostic of Georgia, LLC 1950 Buford Hwy Buford, (866) Jim Moore Rd Dacula, (866) Peachtree Pkwy Norcross, (866) Sugarloaf Pkwy Lawrenceville, (866) Take Care Health Georgia, PC 181 S Clayton St (866) Five Forks Trickum Rd Lawrenceville, (866) Peachtree Pkwy Norcross, (866) HENRY COUNTY, MinuteClinic Diagnostic of Georgia, LLC 5095 Mount Zion Pkwy (866) Fairview Rd Ellenwood, (866) Take Care Health Georgia, PC 1855 Hudson Bridge Rd (866) WTON COUNTY, MinuteClinic Diagnostic of Georgia, LLC 4192 Salem Rd Covington, (866) WALTON COUNTY, MinuteClinic Diagnostic of Georgia, LLC 2720 Loganville Hwy Loganville, (866)

10 Ancillary Providers AIKEN COUNTY, SC Laboratory Quest Diagnostics-Aiken 410 University Pkwy Ste 2200 Aiken, SC (803) ALAMANCE COUNTY, NC Durable Medical Equipment Pediatric Services of America, Inc 2579 Eric Ln Ste. F Burlington, NC (336) Laboratory Quest Diagnostics- Burlington 1161 Huffman Mill Rd Burlington, NC (336) Rehabilitation Therapy Facility HealthSouth-Burlington 422 Huffman Mill Rd Ste Burlington, NC (336) APPLING COUNTY, Durable Medical Equipment Certified Respiratory Services, Inc. 88 Heritage St Baxley, (912) BALDWIN COUNTY, Dialysis Center Milledgeville Dialysis 400 S Wayne St Milledgeville, (478) Durable Medical Equipment Georgia Medical Equipment and Respiratory Services, Inc N Columbia St Suite 109 Milledgeville, (478) Laboratory Quest Diagnostics-Fairhope 312 S Greeno Rd Fairhope, AL (251) BANKS COUNTY, Dialysis Center Fresenius Medical Care River City 2443 brookstone court ste B Columbus, (706) BARROW COUNTY, Dialysis Center Barrow County Dialysis Center 189 W Athens St Ste 9 Winder, (770) Physical, Speech, Occup Therapy Physiotherapy Associates 137 N Broad St Ste E Winder, (770) Radiology Barrow Community Hospital 316 E Broad St P O Box 688 Winder, (770) Georgia Pain Spine Center 15 Medical Dr Ste 302 Cartersville, (678) Dialysis Center BMA-Cartersville 14 Roving Rd Cartersville, (770) Durable Medical Equipment Apria Healthcare, Inc. 945 Joe Frank Harris Pkwy SE Cartersville, (770) Fuller Rehabilition Independent Living Aids- Cartersville 440 Cherokee Pl Cartersville, (770) Hanger Prosthetics & Orthotics, Inc. 17B Felton Pl Cartersville, (770) Phillips Medical Equipment, LLC 144 Kelli Clark Ct SE Cartersville, (678) Home Health Agency Healthfield Home Health Inc 321 N Main St Adairsville, (770) Physical, Speech, Occup Therapy BenchMark Physical Therapy 939 Joe Frank Harris Pkwy SE Cartersville, (770) Prosthetics/Orthotics Apria Healthcare, Inc. 945 Joe Frank Harris Pkwy SE Cartersville, (770) Hanger Prosthetics & Orthotics, Inc. 17B Felton Pl Cartersville, (770) Radiology Cartersville Diagnostic Center, LLC 21 Pointe North Dr Ste 105 Cartersville, (770) Reed Imaging Services LLC 15 Medical Dr Ste 102 Cartersville, (678) Rehabilitation Therapy Facility Advance Rehabilitation of Adairsville 10 Legacy Way Ste E Adairsville, (770) Quest Diagnostics-Bluffton 25 Sheridan Dr Bluffton, SC (843) Quest Diagnostics-Hilton Head 94 Main St Ste D Hilton Head Island, SC (843) BEN HILL COUNTY, Prosthetics/Orthotics Southern Physical & Occupational Therapy Services Inc 112 N Main St P O Box 557 Fitzgerald, (229) BERKELEY COUNTY, SC Dialysis Center Gambro Healthcare-Moncks Corner 642 RC Dennis Blvd Moncks Corner, SC (843) BIBB COUNTY, Ambulatory Surgery Center ANDERSON COUNTY, SC Home Health Agency Pediatric Services of America, Inc 114 Commons Blvd STe. C Piedmont, SC (864) Medical Imaging A Diagnostic Radiology Network Facility 1850 N Columbia St Suite 3 Milledgeville, (800) Physical Therapy Serenity Wellness Spa 107 Sportsman Club Rd Milledgeville, (478) Sleep Disorders Preferred Diagnostic Sleep Centers, Inc. Barrow Medical Ctr 316 N Broad St (Hwy 81) Winder, (770) BARTOW COUNTY, Ambulatory Surgery Center Center for Orthopedic Surgery 15 Medical Dr Cartersville, (770) Hospice In Home Health, Inc 319 E Church St Cartersville, (770) Occupational Therapy Hand Therapy Services 5 Medical Dr Cartersville, (706) Physical Therapy Rehab Associates 695 Henderson Dr Cartersville, (770) BEAUFORT COUNTY, SC Durable Medical Equipment Crutches & Such As 990 Ribaut Rd Suite 101 Beaufort, SC (843) Laboratory Quest Diagnostic - Hilton Head Island 460 William Hilton Pkwy Hilton Head Island, SC (843) Central Georgia Head & Neck Surgery Center 540 Hemlock St (478) Endoscopy Center of Middle Georgia, LLC 610 3rd St (478) Macon Outpatient Surgery, LLC 840 Pine St Ste 840 (478) Medical Eye Associates, Inc Oglethorpe St (478) Dialysis Center BMA-Macon 280 Clinton St Macon, (478) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 9

11 Ancillary Providers Bibb Dialysis Center Dialysis Center of Middle Georgia-Macon 747 2nd St (912) Dialysis Treatment Centers of Macon 745 Pine St (912) East Macon Dialysis 750 Baconsfield Dr Ste 103 Macon, (912) FMC Dialysis Services-South Macon nd St Macon, (478) Renal Treatment Centers- Midtown Macon Dialysis Center 657 Hemlock St (912) Durable Medical Equipment Apria Healthcare, Inc. 182 Steven Dr Macon, (478) C.H. Martin 130 College St (478) ChiChesters Homecare Inc Gray Hwy Macon, (478) DJO, LLC 291 Plantation Centre Dr N Suite 1907 Macon, (800) Lincare, Inc 770 Baconsfield Dr Bldg 1, Macon, (478) Mediquip Rehabilitative Equipment & Supplies 808 Pio Nono Ave Macon, (478) Pediatric Services of America 770 Baconsfield Dr Bldg 1, Macon, (478) Pediatric Services of America, Inc 770 Baconsfield Dr Building 1, Ste. 100 Macon, (478) SleepMed Incorporated (478) SleepMed, Inc 770 Hemlock St (800) Southern Home Respiratory Care 466 Poplar St (478) Home Health Agency Central Georgia Home Care Services, Inc 3780 Eisenhower Pky Ste 5 Macon, (478) Pediatric Services of America, Inc 770 Baconsfield Dr Building 1, Ste. 100 Macon, (478) Physician Support Associates, Inc 1021 Daisy Pk (478) Laboratory Quest Diagnostics-Macon 446 Poplar St (478) Medical Imaging MedCross Imaging, PC 1818 Forsyth St (770) Physical, Speech, Occup Therapy Physiotherapy Associates 6501 Peake Rd Bldg 100 Macon, (478) Prosthetics/Orthotics Apria Healthcare, Inc. 182 Steven Dr Macon, (478) DJO, LLC 291 Plantation Centre Dr N Suite 1907 Macon, (800) Radiology Central Georgia MRI, LLC 5925 Zebulon Rd Macon, (478) Central Georgia PET, LLC 1650 Hardeman Ave (478) Children's Radiology of Atlanta 833 Walnut St (877) Open Macon Imaging Center 833 Walnut St (478) Open MRI of Macon 1504 Hardeman Ave (478) Hardeman Ave (478) Open MRI of Macon, LLC 2140 Riverside Dr Macon, (478) Radiology Center of Macon, LLC 833 Walnut St (478) Sleep Disorders Sleep Services of America, Inc 215 Sheraton Blvd & B Macon, (478) SleepMed Incorporated (478) SleepMed, Inc 770 Hemlock St (800) Southern Sleep Technologies 466 Poplar St (478) BLADEN COUNTY, NC Durable Medical Equipment Pediatric Services of America, Inc 312 S Poplar Street Elizabethtown, NC (910) Home Health Agency Pediatric Services of America, Inc 312 S Poplar Street Elizabethtown, NC (910) Home IV Infusion Agency Pediatric Services of America, Inc 312 S Poplar Street Elizabethtown, NC (910) BRADLEY COUNTY, TN Audiology Audibel Hearing Aid Centers 1011 Keith St NW Ste 2 Cleveland, TN (423) Durable Medical Equipment United Medical, Inc 4681 N Lee Hwy Cleveland, TN (423) Hearing Aid, Sales & Repair Audibel Hearing Aid Centers 1011 Keith St NW Ste 2 Cleveland, TN (423) BRYAN COUNTY, Rehabilitation Therapy Facility West Rehab Services, Inc 9964 Ford Ave Richmond Hill, (912) West Rehab Services, Inc. 205 E Bacon St Pembroke, (912) BULLOCH COUNTY, Dialysis Center FMC of Bullouch County 1355 Brampton Ave Statesboro, (912) Renal Treatment Centers- East Georgia Dialysis 450 Georgia Ave Statesboro, (912) Durable Medical Equipment Apria Healthcare, Inc. 16 College Plz Statesboro, (912) Georgia Home Medical 606 S Zetterower Ave Statesboro, (912) Hanger Prosthetics & Orthotics East, Inc 144 Northside Dr E Statesboro, (912) Walker Home Medical 206 Northside Dr W Suite 1 Statesboro, (912) Home Health Agency Ogeechee Home Health Agency, Inc Fair Rd Suite C Statesboro, (912) Occupational Medicine Southern Wellness and Rehab B. Highway 80 East Statesboro, (912) Orthotics Apria Healthcare, Inc. 16 College Plz Statesboro, (912) Physical Therapy Southern Wellness and Rehab B. Highway 80 East Statesboro, (912) Prosthetics/Orthotics Apria Healthcare, Inc. 16 College Plz Statesboro, (912) Radiology Statesboro Imaging Center, PC 8 Lester Rd Statesboro, (912) Rehabilitation Southern Sports Medicine & Rehabilitation 911 E Inman St Statesboro, (912) BUNCOMBE COUNTY, NC Laboratory Quest Diagnostics-Asheville 41 Oakland Rd Asheville, NC (828) BURKE COUNTY, Home Health Agency University Home Health Services 77 US Highway 25 S Waynesboro, (706) Physical, Speech, Occup Therapy University Home Health Services 77 US Highway 25 S Waynesboro, (706) BUTTS COUNTY, Dialysis Center Grovepark Dialysis 794 McDonough Rd Jackson, (770) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 464 W 3rd St Ste 107 Jackson, (770) CABARRUS COUNTY, NC Laboratory Quest Diagnostics-Concord 845 Church St N Ste 210 Concord, NC (704) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 10

12 Ancillary Providers Chatham Durable Medical Equipment Physical, Speech, Occup Therapy HealthSouth-Concord 470 Lake Concord Rd Concord, NC (704) CALDWELL COUNTY, NC Durable Medical Equipment Pediatric Services of America 2024 Connley Springs Road Lenoir, NC (828) Home IV Infusion Agency Pediatric Services of America 2024 Connley Springs Road Lenoir, NC (828) CAEN COUNTY, Rehabilitation Therapy Facility Advance Rehabilitation of Kingsland 100 Lindsey Ln Kingsland, (912) Kingsland Physical Therapy 130 N Gross Rd Ste 202 Kingsland, (912) CANDLER COUNTY, Dialysis Center FMC Candler County Dialysis 380 Sconyers St Metter, (912) Rehabilitation Better Living Services, Inc 8 N Williams St Metter, (912) CARROLL COUNTY, Ambulatory Surgery Center Carrollton Eye Clinic Ambulatory Surgery Center 158 Clinic Ave Carrollton, (770) West Georgia Endoscopy Center 160 Clinic Ave Carrollton, (770) Dialysis Center Bio-Medical Applications of Carrollton 195 Parkwood Cir Carrollton, (770) FMCNA Villa Rica 130 Prospecter Dr Facility # 3846 Villa Rica, (770) Fresenius Medical Care- Carroll County 157 Clinic Ave Ste 102 Carrollton, (770) Home Health Agency Tanner Medical Center Home Health, Inc. 100 Professional Pl Ste 303 Carrollton, (770) Hospice Tanner Medical Center Hospice Care, Inc. 122 Lee St Carrollton, (770) Physical Therapy Accel Physical Therapy 2000 Mirror Lake Blvd Ste F, Box 160 Villa Rica, (770) Physical, Speech, Occup Therapy Physiotherapy Associates 100 Professional Pl Ste 108 Carrollton, (770) Southern Therapy Service 812 S Park St Carrollton, (770) Southern Therapy Services 690 Dallas Hwy Ste 203 Villa Rica, (770) Southern Therapy Services, Inc 99 Doctors Dr Carrollton, (770) Prosthetics/Orthotics American Prosthetics Inc 1004 Bankhead Hwy Ste 14 Carrollton, (770) Atlanta Prosthetics & Orthotics, Inc N Park St Suite D Carrollton, (770) Radiology Children's Radiology of Atlanta 805 Dixie St Carrollton, (770) Open Carrollton Imaging Center 805 Dixie St Carrollton, (770) Rehabilitation Therapy Facility Matrix Rehabilitation- Georgia, Inc 1004 Bankhead Hwy Bldg A Ste 5 Carrollton, (770) Skilled Nursing Facility IHS at Carrollton Nursing & Rehabilitation Center 2327 N Highway 27 Carrollton, (770) IHS at Pine Knoll Nursing & Rehabilitation Center 156 Pine Knoll Dr Carrollton, (770) CATAWBA COUNTY, NC Laboratory Quest Diagnostics-Hickory 1771 Tate Blvd SE Hickory, NC (828) CATOOSA COUNTY, Durable Medical Equipment American Home Patient 435 Cloud Springs Rd Rossville, (706) American Homepatient 435 Cloud Springs Rd Rossville, (229) Fuller Rehabilition Independent Living Aids 529 Rollins Industrial Blvd Ringgold, (706) Oxygen & More 11 S Commerce Dr Ringgold, (706) Physical, Speech, Occup Therapy BenchMark Physical Therapy-Fort Oglethorpe 1394 Battlefield Pkwy Fort Oglethorpe, (706) CHARLESTON COUNTY, SC Laboratory Quest Diagnostics- Charleston-West Ashley 1843 Ashley River Rd Charleston, SC (843) CHARLTON COUNTY, Rehabilitation Advance Rehabilitation of Folkston 1203 N 3rd St Folkston, (912) CHATHAM COUNTY, Ambulatory Surgery Center Endoscopy Center of Coastal Georgia 519 Stephenson Ave (912) ENT Surgical Center Abercorn St Ste 2 Savannah, (912) Georgia Center for Digestive Diseases, LLC 501 Eisenhower Dr Savannah, (912) Orthopedic Surgery Center 210 E De Renne Ave (912) Plastic Surgery Centerland 5361 Reynolds St (912) Savannah Outpatient Foot & Ankle Surgery Center 310 Eisenhower Dr Building 7B Savannah, (912) Savannah Pain Center, LLC 8 Wheeler St ste 200 (912) Schulze Surgery Center 728 E 67th St (912) Shankliln Plastic Surgery Center, LLC 900 Mohawk St Savannah, (912) The Endoscopy Center, LLC 1139 Lexington Ave Savannah, (912) Urology Surgery Center of Savannah, LLLP 230 E De Renne Ave (912) Audiology Coastal Audiology, Inc 138 Canal St Ste 108 Pooler, (912) Dialysis Center Bio-Medical Applications Coastal Dialysis Center 1460 E Victory Dr Savannah, (912) RAI Drayton Savannah 1020 Drayton St Savannah, (912) West Chatham Dialysis Center 343 Main St Savannah, (912) Durable Medical Equipment American Homepatient 7602 Waters Ave Savannah, (912) Apria Healthcare, Inc. 901 E 65th St (912) C.H. Martin 7135 Hodgson Memorial Dr Ste 1-B Savannah, (912) Coastal Home Respiratory 409 E Montgomery Xrd Ste 5A Savannah, (912) Coastal Therapy, Inc. 911 E 70th St (912) Fuller Rehabilition Independent Living Aids- Savannah Mercy Blvd Bldg 3 Savannah, (912) Medi Home Advantage 5353 Reynolds St Ste 107 (912) Medi Home Care 4131 Ogeechee Rd Ste 123 (912) Chatham Center Dr Ste 2200 (912) Medical Infusion Technologies, Inc 115 Echols Ave Savannah, (912) Peachtree Medical Equipment 3326 Skidaway Rd Savannah, (912) Pediatric Services of America, Inc 37 W Fairmont Ave Unit 204 Savannah, (912) Renewal At Lewis Center/St Joseph/Candler Hosp 225 Candler Rd Ste 102 (912) Savannah Orthotics & Prosthetics, Inc. 906 E 68th St (912) Sleep Well, LLC 340 Hodgson Ct Bldg 200 Ste 2 Savannah, (912) Walker Home Medical 1100 Eisenhower Dr Suite 19 Savannah, (912) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 11

13 Ancillary Providers Chatham Hearing Aid, Sales & Repair Hearing Aid, Sales & Repair Savannah Speech and Hearing Center 1206 E 66th St Savannah, (912) Home Health Agency American Homepatient 7602 Waters Ave Savannah, (912) Gentiva Health Services Inc 329 Commercial Dr Ste 130 Savannah, (912) Healthcare Principals Group, LLC 138 Canal St Ste.207 Pooler, (912) Pediatric Services of America, Inc 37 W Fairmont Ave Unit 204 Savannah, (912) Secure Care, Inc. 351 Commercial Dr Savannah, (912) St. Joseph's Candler Home Healthcare 5510 Paulsen St (912) Laboratory Quest Diagnostics - Savannah 340 Eisenhower Dr Ste 1480 Savannah, (912) Quest Diagnostics- Savannah 340 Eisenhower Dr Ste 1480 Savannah, (912) Quest Diagnostics- Savannah Medical District 815 E 68th St (912) Medical Imaging Boland Women's Imaging PC 1615 E Montgomery Xrd Savannah, (912) Occupational Therapy Pediatric Therapies of Savannah 6555 Abercorn St ste 221 (912) Physical, Speech, Occup Therapy Radiology Associates of Savannah, PC 5105 Paulsen St Suite C140 (912) Savannah Chatham Imaging Services Mercy Blvd Savannah, (912) Rehabilitation Recovery Place 835 E 65th St (912) Rehabilitation Therapy Facility West Rehab Services Inc 1000 Towne Center Blvd Ste 602 Pooler, (912) West Rehab Services, Inc 109-C Minus Ave Savannah, (912) West Rehab Services, Inc. 100 Blue Fin Cir Ste 3 Savannah, (912) Eisenhower Dr Savannah, (912) Skilled Nursing Facility CHATTOO COUNTY, Dialysis Center Harbin Clinic Summerville Dialysis Center Highway 27 Summerville, (706) Rehabilitation Therapy Facility Advance Rehabilitation & Consulting, Inc Highway 27 Ste 1 Summerville, (706) CHEROKEE COUNTY, Ambulatory Surgery Center Woodstock Endoscopy Center, LLC 2001 Professional Way Ste 270 Woodstock, (404) Audiology Durable Medical Equipment BioKinetics, Inc 3013 High Vista Walk (770) DJO, LLC 1131 Etowah Valley Ln (800) Physiotherapy Associates 720 Transit Ave ste 102 Canton, (678) SleepMed Incorporated 2230 Towne Lake Pkwy Bldg 1000 (770) Occupational Therapy Towne Lake Hand Therapy, Inc Towne Lake Pkwy Bldg. 600 Ste 110 (770) Physical Therapy Woodstock Physical Therapy & Joint Medicine, LLC 1816 Eagle Dr Bldg 100, (770) Open Woodstock Imaging Center 2001 Professional Way Ste 160 Woodstock, (770) Quantum Radiology - Kennestone Towne Lake Imaging 120 Stonebridge Pkwy (678) Wellstar Kennestone Medical Imaging Center at Towne Lake 120 Stonebridge Pkwy (678) Woodstock Diagnostic Imaging 300 Parkbrooke Pl Ste 170 (678) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 230 Marietta Hwy Ste 120 Canton, (770) Skilled Nursing Facility IHS at Woodstock Nursing & Rehabilitation Center 105 Arnold Mill Rd Woodstock, (770) Home IV Infusion Agency American Homepatient 7602 Waters Ave Savannah, (912) Infusion Partners 1000 Business Center Dr Ste 120 (912) Medical Infusion Technologies, Inc 115 Echols Ave Savannah, (912) Venous Access Services, LLC 1 Johnston St Unit 6 (912) Hospice Hospice Savannah, Inc 1352 Eisenhower Dr Savannah, (912) Candler Hospital 5353 Reynolds St (912) Coastal Therapy, Inc. 911 E 70th St (912) St. Joseph's/Candler Hlth Syst Mercy Blvd Savannah, (912) Prosthetics/Orthotics Apria Healthcare, Inc. 901 E 65th St (912) Radiology Open MRI of Savannah 4815 Waters Ave Savannah, (912) PET Imaging Center of Savannah, LLC 7135 Hodgson Memorial Dr Ste 10A Savannah, (770) IHS at Savannah Beach Nursing & Rehabilitation Center 90 Van Horne Ave Tybee Island, (912) Riverview Health & Rehabilitation Center 6711 La Roche Ave Savannah, (912) Sleep Disorders SleepCare Institute, Inc 836 E 65th St Bldg 2 (912) The Sleep Disorders Center at St. Josephs Hospital Mercy Blvd Suiate 4 Savannah, (912) Progressive Audiology Center, Inc Towne Lake Pkwy Bldg 800, Ste 120 (770) Diagnostic Facility Atlantic Diagnostic Center, LLC 720 Transit Ave Canton, (770) Dialysis Center FMC Dialysis Services Woodstock 100 Londonderry Ct Woodstock, (770) RCC Northern Georgia 411 Hospital Rd Canton, (770) Woodstock Dialysis 2001 Professional Pky Woodstock, (678) Physical, Speech, Occup Therapy BenchMark Physical Therapy 2230 Towne Lake Pkwy Bldg 1200, & 110 (770) Physiotherapy Associates 655 Molly Ln (770) Prosthetics/Orthotics DJO, LLC 1131 Etowah Valley Ln (800) Radiology Children's Radiology of Atlanta 2001 Professional Pky Ste 160 Woodstock, (770) Sleep Disorders SleepMed Incorporated 2230 Towne Lake Pkwy Bldg 1000 (770) CLARKE COUNTY, Ambulatory Surgery Center American Eye Surgery Center 651 S Milledge Ave Athens, (706) Georgia Lithotripsy & Laser Center 120 Trinity Pl Athens, (706) Dialysis Center Dialysis Center of Athens 210 Hawthorne Park (706) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 12

14 Ancillary Providers Cobb Ambulatory Surgery Center Gambro Healthcare-Athens West 2047 Prince Ave (706) RCG Clarke County 850 Prince Ave (706) Durable Medical Equipment Apria Healthcare, Inc Jefferson Rd Athens, (706) Fuller Rehabilition Independent Living Aids- Athens 3190 Atlanta Hwy Suite 15-A (706) Hanger Prosthetics & Orthotics East, Inc. 698 S Milledge Ave Athens, (800) Hanger Prosthetics & Orthotics, Inc Prince Ave (706) Home Medical Professional 191 Alps Rd ste 8 (706) Lincare, Inc 2440 W Broad St Ste 9 (706) Hospice Heartland Hospice Services 330 Research Dr Suite 130 Athens, (706) MRI Open MRI of Athens 845 Prince Ave (706) Physical Therapy East Athens Physical Therapy 665 Gaines School Rd Athens, (706) Horizon Physical Therapy and Rehabilitation, Inc Prince Ave (706) Physical, Speech, Occup Therapy Physiotherapy Associates 788 Prince Ave ste C (706) Prosthetics/Orthotics Apria Healthcare, Inc Jefferson Rd Athens, (706) Atlanta Prosthetics & Orthotics, Inc Hawthorne Ave Suite L (706) Hanger Prosthetics & Orthotics, Inc Prince Ave (706) Radiology Athens Diagnostic Center 1063 Baxter St (706) Open MRI of Athens 845 Prince Ave (706) Rehabilitation Therapy Facility HealthSouth Sports Medicine & Rehab. Center 1000 Hawthorne Ave Ste J (706) Skilled Nursing Facility Guardian Home Care of Central Georgia, LLC 435 Hawthorne Ave (706) Speech/Hearing Therapy ABC Pediatric Therapy Partners, Inc 1175 Oglethorpe Ave (706) CLAYTON COUNTY, Ambulance Lifestar Response dba Care Ambulance 277 Southfield Pkwy Forest Park, (404) Ambulatory Surgery Center Akstein Eye Center 86 Upper Riverdale Rd (770) Atlanta South Endoscopy Center 34 Upper Riverdale Road Suite 201 (678) Clayton Cataract and Laser Surgery Center 1000 Corporate Center Dr Ste 180 Morrow, (770) G.I. Endoscopy Center 6555 Professional Pl (770) Southern Crescent Endoscopy Center 7402 Davidson Pkwy S (770) Surgery Center At Mt. Zion 4000 Corporate Center Dr Morrow, (770) Dialysis Renal Care Group Clayton County 335 Upper Riverdale Rd -1 Jonesboro, (770) Dialysis Center Forest Park Dialysis 380 Forest Pkwy Forest Park, (404) Jonesboro Dialysis 129 King St Jonesboro, (770) Renal Treatment Centers- Jonesboro Dialysis 129 King St Jonesboro, (770) Southern Crescent Dialysis Center 275 Upper Riverdale Rd SW (770) Durable Medical Equipment American Homecare Supply, Georgia, Inc 4820 Clark Howell Hwy -4 Atlanta, (404) Hanger Prosthetics & Orthotics, Inc. 155 Medical Way (770) SleepMed, Inc 217 Arrowhead Blvd 3 Jonesboro, (800) Home Health Agency Mobile Home Health Services, Inc 203 Medical Way (770) Hospice Embracing Hospice Care of South Atlanta LLC 315 Arrowhead Blvd Jonesboro, (678) In Home Health, Inc Lake Ridge Pkwy Riverdale, (770) Laboratory Quest Diagnostics - Riverdale 107 Upper Riverdale Rd SW (770) Quest Diagnostics-Riverdale 83 Upper Riverdale Rd Ste 120 (770) Physical Therapy Children's Healthcare of Atlanta at Mt. Zion 2201 Mount Zion Pkwy Morrow, (404) Excel Physical therapy 1883 McDonough Rd Bldg 200 Hampton, (678) Physical, Speech, Occup Therapy Morrow Physical Therapy 3000 Corporate Center Dr Ste 255 Morrow, (770) Physiotherapy Associates 1669 Phoenix Pkwy Ste 102 Atlanta, (770) Upper Riverdale Rd 10 Jonesboro, (770) Forest Pky Ste 14 Forest Park, (404) Rehab South Physical Therapy-Southside 150 Medical Way Ste E1 (770) Prosthetics/Orthotics Hanger Prosthetics & Orthotics, Inc. 155 Medical Way (770) Radiology Am-Med Medical Imaging 34 Upper Riverdale Road Suite 102 (770) Children's Radiology of Atlanta 237 Medical Way (770) Open MRI Centers of Georgia 6584 Professional Pl Suite D (770) Radiology Associates of Clayton 33 Upper Riverdale Rd SW Ste 105 (770) Riverdale Radiology Center, LLC 237 Medical Way (770) South Atlanta Radiology Associates, P.C. 119 Upper Riverdale Rd SW (770) Rehabilitation Therapy Facility Concentra Health Services 1368 Southlake Plaza Dr Morrow, (678) Moreland Ave Conley, (770) Clark Howell Hwy Atlanta, (404) HealthSouth Sports Medicine & Rehab. Center 6319 A Jonesboro Rd Morrow, (770) HealthSouth Sports Medicine & Rehabilitation Ctr 275 Upper Riverdale Rd SW (770) Southern Regional Medical Center 11 Upper Riverdale Rd SW (770) Sleep Disorders Do You Snore, LLC 6555 Professional Pl (404) SleepMed, Inc 217 Arrowhead Blvd 3 Jonesboro, (800) The Sleep Disorders Centers of Southeastern Lung Care in South Atlanta 181 Upper Riverdale Rd SW Building A, Suite 2 (770) Speech/Hearing Therapy Children's Healthcare of Atlanta at Mt. Zion 2201 Mount Zion Pkwy Morrow, (404) COBB COUNTY, Ambulatory Surgery Center Ambulatory Foot & Leg Surgical Center 1652 Mulkey Rd (770) Cobb Endoscopy Center, LLC 3969 S Cobb Dr SE Suite 207 Smyrna, (770) Cobb Foot & Leg Surgical Center 792 Church St Suite 401 (770) East West Surgery Center, LP 2041 Mesa Valley Way Ste 125 (678) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 13

15 Ancillary Providers Cobb Ambulatory Surgery Center GI Diagnostics Endoscopy Center, LLC 2550 Windy Hill Rd SE Ste 302 Marietta, (770) Marietta Eye Clinic DBA Marietta Eye Surgery 895 Canton Rd Bldg 200 Suite 300 (678) Marietta Surgical Center 780 Canton Rd (770) Northwest Georgia Orthopeadic Surgery Center 2550 Windy Hill Rd SE Ste 218 Marietta, (770) The Center for Spine Procedures, PC 335 Roselane St NW (770) Urology Associates Surgery Center, LLC 300 Tower Rd Suite 150 (678) Wellstar Kennestone Surgery Center-Outpatient 677 Church St (770) Westside Endoscopy Center 3825 Medical Park Dr (770) Audiology Children's Healthcare of Atlanta in Cobb 1371 Church Street Ext (770) Progressive Audiology Center, Inc 3960 Shallowford Rd Marietta, (770) Diagnostic Facility A Diagnostic Radiology Network Facility 2501 Chastain Meadows Pkwy Marietta, (800) Atlantic Diagnostic Center, LLC 1620 Mulkey Rd (770) Cardiac CT Imaging Center at 55 Witcher Street 55 Whitcher St Suite 150 (678) Dialysis Center Bio-Medical Applications of South Cobb 3565 Austell Rd SW Ste 13 Marietta, (770) Cobb Nephrology Dialysis Center, Inc Medical Park Dr (770) Fresenius Medical Care of North Cobb 1392 Bells Ferry Rd Marietta, (770) RCC Marietta 1277 Kennestone Cir Ste 600 Marietta, (770) Renal Care Group Smyrna 2700 Highlands Pkwy SE Smyrna, (678) Durable Medical Equipment Access Homecare Services, Inc 2211 New Market Pkwy SE Ste 156 Marietta, (678) Advanced Home Medical 1395 S Marietta Pkwy SE Bldg 100, Ste 106 Marietta, (770) American Homecare Supply, Georgia, Inc 2010 Cobb International Blvd NW Ste D Kennesaw, (770) Apria Healthcare, Inc New Market Pkwy SE Ste 156 Marietta, (770) Byram Healthcare 220 Cobb Pkwy N Marietta, (877) C.H. Martin 472 N Sessions St NW (770) DJO, LLC 707 WHITLOCK AVE STE F3 Marietta, (800) Dynamic Orthotics & Prosthetics, Inc The Exchange SE Suite 375 Atlanta, (770) Hanger Prosthetics & Orthotics, Inc. 124 Powers Ferry Rd SE Marietta, (770) Healthfield Inc 1395 S Marietta Pkwy SE Ste 910 Marietta, (770) Hi-Tech Healthcare, Inc 718 Cherokee St (770) Lincare, Inc 4451 Atlanta Rd SE Ste 106 Smyrna, (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, (770) Physiotherapy 4579 S Cobb Dr SE ste 100 Smyrna, (770) Source One Medical, Inc 2121 New Market Pkwy SE Suite 108 Marietta, (770) Vision Quest Industries, Inc Lake Acworth Dr Acworth, (800) Wellstar Home Medical Equipment 805 Sandy Plains Rd Marietta, (770) Home Health Agency Coram Alternate Site Services, Inc New Market Pkwy SE Suite 106 Marietta, (770) Healthfield Home Health Inc 1395 S Marietta Pkwy SE Ste 910 Marietta, (770) Matria Healthcare, Inc 1850 Parkway Pl SE Marietta, (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, (770) The Healthfield Group, Inc Riverwood Pkwy SE Suite 1400 Atlanta, (770) Wellstar Home Health 805 Sandy Plains Rd Marietta, (770) Wellstar Private Homecare Services 805 Sandy Plains Rd Marietta, (770) Home IV Infusion Agency Lacey's Vital Care 790 Church St ste 170 (770) Pediatric Services of America, Inc 2217 Roswell Rd 100 Marietta, (770) Premier Healthcare Solutions, LLC 4451 Atlanta Rd SE Ste 136 Smyrna, (770) Hospice Healthfield Hospice Services Inc 1395 S Marietta Pkwy SE Ste 902 Marietta, (770) Heritage Hospice, Inc Kennestone Cir 213 Marietta, (770) Wellstar Community Hospice 4040 Hospital West Dr (770) Laboratory Quest Diagnostics - Marietta 790 Church Street Ext (770) MRI MRI & Imaging of Marietta 300 Tower Rd (770) Occupational Therapy East Cobb Shoulder, Elbow, Hand Therapy 3901 Roswell Rd -B Marietta, (770) Venture Hand Therapy 5041 Dallas Hwy Powder Springs, (770) Physical Therapy Benchmark Physical therapy 1025 E West Connector ste 4 (770) BenchMark Physical Therapy - Kennestone 400 Tower Rd Suite 140 (770) Children's Healthcare of Atlanta at Town Center 2985 George Busbee Pkwy NW Kennesaw, (404) Remobility, Inc 3901 Roswell Rd -A Marietta, (770) Venture Hand Therapy 5041 Dallas Hwy Powder Springs, (770) Physical, Speech, Occup Therapy Axiom Physical Therapy 736 Johnson Ferry Rd -12 Marietta, (770) BenchMark Physical Therapy 2550 Windy Hill Rd SE Ste 208 Marietta, (770) Building Blocks Pediatric Therapy, Inc Johnson Ferry Rd -50 Marietta, (404) Georgia Physical Therapy, LLC (NovaCare) 1121 Johnson Ferry Rd Ste 210 Marietta, (770) Cherry St Ste 1 (770) Chicopee Dr (770) Red Bud Rd, Sequoia Shopping Center (706) Church St (770) OrthoSport Physical Therapy, LLC 3450 Acworth Due West Rd NW Ste 310 Kennesaw, (770) Shallowford Rd Ste 415 Marietta, (770) Physiotherapy Associates 1431 White Cir Marietta, (770) N Park Pl SE Ste 230 Atlanta, (770) Post Oak Tritt Rd Ste 400 Marietta, (770) Windy Hill Rd SE Ste 208 Marietta, (770) S Cobb Dr SE Smyrna, (770) Campbell Hill St NW Ste 460 (770) Physiotherapy Assoicates 3105 Creekside Village Dr NW Ste 01 Kennesaw, (678) Remobility, Inc 4131 Christacy Way Marietta, (770) Wellstar Cobb Hospital- Outpatient Rehabilitation 3950 Austell Rd (770) Wellstar Kennestone Hospital-Outpatient Rehabilitation 100 Lacy St NW (770) Wellstar Windy Hill Hospital- Outpatient Rehabiliation 2540 Windy Hill Rd SE Marietta, (770) Prosthetics/Orthotics Apria Healthcare, Inc New Market Pkwy SE Ste 156 Marietta, (770) Children's Healthcare of Atlanta in Cobb 1371 Church Street Ext (770) DJO, LLC 707 WHITLOCK AVE STE F3 Marietta, (800) Hanger Prosthetics & Orthotics, Inc. 124 Powers Ferry Rd SE Marietta, (770) Radiology East Cobb MRI Center LLC 1197 Johnson Ferry Rd Marietta, (770) A member may seek services at any Ancillary Provider listed above under the direction of their Primary Care Physician(PCP) as required by their benefit plan. If PCP direction is required and the member seeks care without contacting their PCP, services may be denied. Please consult your Certificate of Coverage for full benefit information. Please visit us on the 14