Healthcare Provider Details

I. General information

NPI: 1154579191
Provider Name (Legal Business Name): CF HEALTH MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 10/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WASHINGTON AVE SUITE C
GAINESVILLE GA
30501-4100
US

IV. Provider business mailing address

3 WASHINGTON AVE SUITE C
GAINESVILLE GA
30501-4100
US

V. Phone/Fax

Practice location:
  • Phone: 770-534-2300
  • Fax: 770-534-2900
Mailing address:
  • Phone: 770-534-2300
  • Fax: 770-534-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number26067
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number061001
License Number StateGA

VIII. Authorized Official

Name: MS. VICTORIA MARIE CAMBURAKO
Title or Position: OFFICE MANAGER
Credential: OWNER/CEO
Phone: 770-534-2300