1841233202 NPI number — CHMG OF ATLANTA, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841233202 NPI number — CHMG OF ATLANTA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHMG OF ATLANTA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACCESS HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841233202
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12900 FOSTER ST SUITE 400
Provider Second Line Business Mailing Address:
ATTENTION: RUTH SCHWARTZ
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 KENTON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25311-1256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-814-2800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHWARTZ
Authorized Official First Name:
RUTH
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR LICENSURE
Authorized Official Telephone Number:
913-814-2288

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810002842 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".