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General NPI Number Information
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NPI Number | 1659858058
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Entity Type | Organization
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Legal Business Name | IGGY GROUP, LLC
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 1119 TUMLIN CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-2702
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Country | US
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Telephone | 404-310-9690
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Fax | 770-822-9152
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Provider Business Mailing Address
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Address Line | 1119 TUMLIN CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-2702
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Country | US
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Telephone | 404-310-9690
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Fax | 770-822-9152
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. VALENTINE OBIAJULU IGWEBUIKE SR.
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Credential |
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Telephone | 404-310-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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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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