Healthcare Provider Details

I. General information

NPI: 1033291885
Provider Name (Legal Business Name): HORIZONS HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2795 MAIN ST W #27
SNELLVILLE GA
30078-3164
US

IV. Provider business mailing address

2795 MAIN ST W #27
SNELLVILLE GA
30078-3164
US

V. Phone/Fax

Practice location:
  • Phone: 770-985-8001
  • Fax:
Mailing address:
  • Phone: 770-985-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH LAWLESS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 770-985-8001