Healthcare Provider Details

I. General information

NPI: 1912375148
Provider Name (Legal Business Name): ZYWIE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 FINDLEY RD STE 360
JOHNS CREEK GA
30097-1464
US

IV. Provider business mailing address

12000 FINDLEY RD STE 360
JOHNS CREEK GA
30097-1464
US

V. Phone/Fax

Practice location:
  • Phone: 678-514-3158
  • Fax: 678-514-3609
Mailing address:
  • Phone: 678-514-3158
  • Fax: 678-514-3609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number14020782
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: LATHA GANESHAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 678-514-3158