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General NPI Number Information
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NPI Number | 1245609007
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Entity Type | Organization
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Legal Business Name | CHEMON HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 2701 WINSLEY DR SW
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City | MARIETTA
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State | GA
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Zip | 30064-5714
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Country | US
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Telephone | 770-702-1927
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Fax | 770-659-2738
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Provider Business Mailing Address
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Address Line | 2701 WINSLEY DR SW
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City | MARIETTA
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State | GA
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Zip | 30064-5714
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Country | US
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Telephone | 770-656-8967
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Fax | 770-659-2738
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. EMMANUEL EGBUZIEM
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Credential |
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Telephone | 770-656-8967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 033-R-1231
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 033-R-1231
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License Number State |
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