Healthcare Provider Details

I. General information

NPI: 1134762206
Provider Name (Legal Business Name): THE AICHER CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2019
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W CHURCH ST STE 101
JASPER GA
30143-1618
US

IV. Provider business mailing address

385 LUM CROWE RD
ROSWELL GA
30075-6879
US

V. Phone/Fax

Practice location:
  • Phone: 404-796-7011
  • Fax: 404-796-7099
Mailing address:
  • Phone: 770-906-6818
  • Fax: 404-796-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WINSTON HAROLD GANDY JR.
Title or Position: MANAGING PARTNER/ OWNER
Credential: M.D.
Phone: 404-796-7011