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General NPI Number Information
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NPI Number | 1881495646
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Entity Type | Organization
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Legal Business Name | SYNERGY HOMECARE OF FAYETTEVILLE GA LLC
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 288 HIGH WAY 314 SUITE C
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City | FAYETTEVILLE
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State | GA
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Zip | 30214
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Country | US
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Telephone | 470-352-0524
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Fax |
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Provider Business Mailing Address
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Address Line | 165 KEATON DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30215-2035
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Country | US
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Telephone | 470-352-0524
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NIGEL GAUNTLETT
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Credential |
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Telephone | 470-352-0524
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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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