Healthcare Provider Details

I. General information

NPI: 1932459583
Provider Name (Legal Business Name): JUST STAY EXAM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2012
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 WOODMONT LN NW STE 1353
ATLANTA GA
30318-2866
US

IV. Provider business mailing address

1445 WOODMONT LN NW STE 1353
ATLANTA GA
30318-2866
US

V. Phone/Fax

Practice location:
  • Phone: 470-615-1884
  • Fax:
Mailing address:
  • Phone: 470-615-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: PERRI SANDS
Title or Position: DIRECTOR
Credential:
Phone: 470-615-1884