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General NPI Number Information
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NPI Number | 1346411170
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Entity Type | Organization
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Legal Business Name | EM HEARING AND SCREENING
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 2777 JEFFERSON ST STE 4
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City | AUSTELL
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State | GA
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Zip | 30168-4054
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Country | US
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Telephone | 404-396-5560
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Fax | 678-567-2906
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Provider Business Mailing Address
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Address Line | 2777 JEFFERSON ST STE 4
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City | AUSTELL
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State | GA
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Zip | 30168-4054
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Country | US
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Telephone | 404-396-5560
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Fax | 678-567-2906
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Authorized Official
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Title or Position | PRESIDENT
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Name | EARNEST FABRE
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Credential |
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Telephone | 404-396-5560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | AUD003646
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License Number State | NC
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