Healthcare Provider Details

I. General information

NPI: 1043451784
Provider Name (Legal Business Name): HEALTHCHECK SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 FERN PARK LN
DAWSONVILLE GA
30534-8417
US

IV. Provider business mailing address

72 FERN PARK LN
DAWSONVILLE GA
30534-8417
US

V. Phone/Fax

Practice location:
  • Phone: 770-888-8988
  • Fax:
Mailing address:
  • Phone: 770-888-8988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number013010
License Number StateGA

VIII. Authorized Official

Name: MR. MICHAEL WALL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 770-888-8988