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General NPI Number Information
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NPI Number | 1598580771
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Entity Type | Organization
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Legal Business Name | 4 PLUS 1 ENTERPRISES, LLC
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 150 STANLEY CT STE B
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5215
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Country | US
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Telephone | 678-373-7271
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 TIMBERLINE TRCE
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City | SNELLVILLE
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State | GA
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Zip | 30078-6675
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Country | US
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Telephone | 424-204-3403
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | JASMINE NICOLE HUTCHINSON
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Credential | RN
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Telephone | 424-204-3403
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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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