Healthcare Provider Details

I. General information

NPI: 1902123417
Provider Name (Legal Business Name): ZIBRAZ MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4259 ELK RUN
DOUGLASVILLE GA
30135-4261
US

IV. Provider business mailing address

4259 ELK RUN
DOUGLASVILLE GA
30135-4261
US

V. Phone/Fax

Practice location:
  • Phone: 770-577-0611
  • Fax: 770-577-8211
Mailing address:
  • Phone: 770-577-0611
  • Fax: 770-577-8211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK OKPES EHIARINMWIAN
Title or Position: PRESIDENT/CEO/OWNER
Credential:
Phone: 770-577-0611