Healthcare Provider Details

I. General information

NPI: 1568901395
Provider Name (Legal Business Name): ADVIR HEALTH CARE SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 LINCOLN JONES RD STE B
ELLENWOOD GA
30294-1828
US

IV. Provider business mailing address

3851 LINCOLN JONES RD STE B
ELLENWOOD GA
30294-1828
US

V. Phone/Fax

Practice location:
  • Phone: 404-829-2682
  • Fax: 404-228-3064
Mailing address:
  • Phone: 404-829-2682
  • Fax: 404-228-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR L WASHINGTON
Title or Position: OWNER
Credential:
Phone: 404-829-2682