MEDICARE: A2H2

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QC1500X	Community Health Clinic/Center

General Provider Information

NPI Number	:	1558750141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A2H2

Provider Business Mailing Address
First Line	:	2909 PEACHTREE RD; NW;
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305
Country	:	US
Telephone Number	:	404-227-2417
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 PEACHTREE RD; NW;
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305
Country	:	US
Telephone Number	:	404-227-2417
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MR. CHRIS JOHNSON
Credential	:
Telephone Number	:	404-227-2417

Provider Enumeration Date	:	01/20/2015
Last Update Date	:	01/20/2015

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