Healthcare Provider Details

I. General information

NPI: 1114416310
Provider Name (Legal Business Name): FULTON COUNTY GOVERNMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 05/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 VERNON WOODS DR
SANDY SPRINGS GA
30328-3204
US

IV. Provider business mailing address

141 PRYOR ST SW STE 7001
ATLANTA GA
30303-3468
US

V. Phone/Fax

Practice location:
  • Phone: 404-612-2360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELBA MCNEIL
Title or Position: ACCOUNTING SUPERVISOR
Credential:
Phone: 404-613-1257