1568783231 NPI number — ATLANTA METRO FIRST ASSISTANTS 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 1568783231 NPI number — ATLANTA METRO FIRST ASSISTANTS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTA METRO FIRST ASSISTANTS 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:
Provider Other Organization Name Type Code:
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:
1568783231
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5656 JONESBORO RD
Provider Second Line Business Mailing Address:
SUITE 111 #358
Provider Business Mailing Address City Name:
LAKECITY
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30260-3853
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-547-3055
Provider Business Mailing Address Fax Number:
404-366-5096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3916 BROOKGATE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENWOOD
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30294-2385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-547-3055
Provider Business Practice Location Address Fax Number:
404-366-5096
Provider Enumeration Date:
06/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BAKER
Authorized Official First Name:
ELEAZAR
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
404-547-3055

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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