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General NPI Number Information
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NPI Number | 1396372363
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Entity Type | Organization
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Legal Business Name | LAMAR AGENCY
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 3040 PEACHTREE RD NW UNIT 1010
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City | ATLANTA
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State | GA
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Zip | 30305-2290
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Country | US
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Telephone | 770-239-1471
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Fax | 844-597-1762
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Provider Business Mailing Address
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Address Line | 3085 BROMBLEY DR SE
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City | CONYERS
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State | GA
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Zip | 30013-6483
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Country | US
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Telephone | 404-884-9447
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Fax | 844-597-1762
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALTHISHA LATRICE MATTHEWS
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Credential |
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Telephone | 404-884-9447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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