1265722136 NPI number — EWS ASSOCIATES, LLC

Table of content: (NPI 1265722136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265722136 NPI number — EWS ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EWS ASSOCIATES, LLC
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:
Provider Other Organization Name Type Code:
6
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:
1265722136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1633 MOUNT VERNON RD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30338-4273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-999-2446
Provider Business Mailing Address Fax Number:
770-551-0675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1633 MOUNT VERNON RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30338-4273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-999-2446
Provider Business Practice Location Address Fax Number:
770-551-0675
Provider Enumeration Date:
04/13/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SCHUETZ
Authorized Official First Name:
ERICH
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
678-999-2446

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  044-R-0762 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 003146021A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com