Healthcare Provider Details

I. General information

NPI: 1760657159
Provider Name (Legal Business Name): POS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2008
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 SALEM GATE WAY SE
CONYERS GA
30013-1637
US

IV. Provider business mailing address

1237 SALEM GATE WAY SE
CONYERS GA
30013-1637
US

V. Phone/Fax

Practice location:
  • Phone: 770-922-3068
  • Fax: 770-922-6607
Mailing address:
  • Phone: 770-922-3068
  • Fax: 770-922-6607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RUTH ROBERTS
Title or Position: OWNER
Credential:
Phone: 770-922-3068