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General NPI Number Information
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NPI Number | 1457129793
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Entity Type | Organization
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Legal Business Name | ENVISION HEALTHCEUTICALS LLC
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 629 AIRPORT RD STE J
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-4474
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Country | US
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Telephone | 678-251-8180
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Fax | 770-545-8840
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Provider Business Mailing Address
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Address Line | 1137 TROPHY CLUB AVE
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City | DACULA
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State | GA
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Zip | 30019-7583
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Country | US
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Telephone | 678-251-8180
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. MIKELLE COLEBY
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Credential |
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Telephone | 678-251-8180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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