Healthcare Provider Details

I. General information

NPI: 1396211694
Provider Name (Legal Business Name): EVERYBODY VS CANCER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 FLAT SHOALS PKWY STE 107
DECATUR GA
30034-5040
US

IV. Provider business mailing address

4555 FLAT SHOALS PKWY STE 107
DECATUR GA
30034-5040
US

V. Phone/Fax

Practice location:
  • Phone: 470-272-6651
  • Fax:
Mailing address:
  • Phone: 470-272-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: NIKICHIA BUTLER
Title or Position: FOUNDER
Credential: NURSE
Phone: 470-272-6651