Healthcare Provider Details

I. General information

NPI: 1376907220
Provider Name (Legal Business Name): MR. NEHEMIAH SLAUGHTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2483 HERITAGE VLG STE 16-188
SNELLVILLE GA
30078-6140
US

IV. Provider business mailing address

2483 HERITAGE VLG STE 16-188
SNELLVILLE GA
30078-6140
US

V. Phone/Fax

Practice location:
  • Phone: 678-612-4933
  • Fax:
Mailing address:
  • Phone: 678-612-4933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: