Healthcare Provider Details

I. General information

NPI: 1750068565
Provider Name (Legal Business Name): ANK HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11305 BELL RD STE 105
JOHNS CREEK GA
30097-9504
US

IV. Provider business mailing address

11305 BELL RD STE 105
JOHNS CREEK GA
30097-9504
US

V. Phone/Fax

Practice location:
  • Phone: 678-787-5001
  • Fax:
Mailing address:
  • Phone: 678-787-5001
  • Fax:

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 Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAMELA KUFAHL
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 678-787-5001