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General NPI Number Information
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NPI Number | 1427310507
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Entity Type | Organization
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Legal Business Name | HEALTH CARE FOR LIFE GA, LLC
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 5607 GLENRIDGE DR NE STE 430
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City | ATLANTA
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State | GA
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Zip | 30342-7200
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Country | US
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Telephone | 404-497-4119
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Fax | 404-497-4114
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Provider Business Mailing Address
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Address Line | 5607 GLENRIDGE DR NE STE 430
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City | ATLANTA
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State | GA
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Zip | 30342-7200
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Country | US
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Telephone | 404-497-4119
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Fax | 404-497-4114
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Authorized Official
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Title or Position | PARTNER/MEMBER
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Name | DR. STUART M GREENBERG
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Credential | O.D.
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Telephone | 256-332-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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