Healthcare Provider Details

I. General information

NPI: 1336440221
Provider Name (Legal Business Name): NATIONS HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LANIER AVE W SUITE 202
FAYETTEVILLE GA
30214-7636
US

IV. Provider business mailing address

500 LANIER AVE W SUITE 202
FAYETTEVILLE GA
30214-7636
US

V. Phone/Fax

Practice location:
  • Phone: 770-461-0222
  • Fax: 866-520-9539
Mailing address:
  • Phone: 770-461-0222
  • Fax: 866-520-9539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number056-R-0765
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number056-R-0765
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number056-R-0765
License Number StateGA

VIII. Authorized Official

Name: EMMANUEL WAHIWE
Title or Position: DIRECTOR OF ADMINISTRATION
Credential:
Phone: 770-912-7800