Healthcare Provider Details

I. General information

NPI: 1518022821
Provider Name (Legal Business Name): FOR THE CHILDREN'S HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 HERODIAN WAY SE SUITE 150
SMYRNA GA
30080-8581
US

IV. Provider business mailing address

2400 HERODIAN WAY SE SUITE 150
SMYRNA GA
30080-8581
US

V. Phone/Fax

Practice location:
  • Phone: 770-850-8588
  • Fax: 770-850-8789
Mailing address:
  • Phone: 770-850-8588
  • Fax: 770-850-8789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA H NATHANSON-LIPPITT
Title or Position: PRESIDENT
Credential: MD
Phone: 770-850-8588