Healthcare Provider Details

I. General information

NPI: 1851209357
Provider Name (Legal Business Name): JIMMY ALBERT WEST JR. CHWC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 S JACKSON ST STE 228
ALBANY GA
31701-2882
US

IV. Provider business mailing address

230 S JACKSON ST STE 228
ALBANY GA
31701-2882
US

V. Phone/Fax

Practice location:
  • Phone: 229-733-2065
  • Fax:
Mailing address:
  • Phone: 229-733-2065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number180882922
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: