Healthcare Provider Details

I. General information

NPI: 1679358501
Provider Name (Legal Business Name): BE STROWN ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4080 HIGHWAY 92
DOUGLASVILLE GA
30135-4404
US

IV. Provider business mailing address

PO BOX 366433
ATLANTA GA
30336-6433
US

V. Phone/Fax

Practice location:
  • Phone: 470-470-6593
  • Fax:
Mailing address:
  • Phone: 470-352-6593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: ROBYN STROWN
Title or Position: OWNER
Credential:
Phone: 470-352-6593