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General NPI Number Information
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NPI Number | 1295611556
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Entity Type | Organization
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Legal Business Name | ATHENS MODEL NEIGHBORHOOD HEALTH CENTER INC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 675 COLLEGE AVE
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City | ATHENS
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State | GA
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Zip | 30601-2635
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Country | US
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Telephone | 706-546-5526
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Fax | 706-546-5687
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Provider Business Mailing Address
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Address Line | 402 MCKINLEY DR
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City | ATHENS
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State | GA
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Zip | 30601-3261
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Country | US
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Telephone | 706-543-1145
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Fax | 706-549-0056
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | DR. SAMAN KAZEMI
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Credential | PHARMD
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Telephone | 706-543-1145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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