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NPI Code Detail

MEDICARE: IRISHMEN LLC

MEDICARE: IRISHMEN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0901XPublic Health & General Preventive Medicine Physician

General Provider Information

NPI Number : 1053937003
Entity Type Code : Organization
Provider Name (Legal Business Name) : IRISHMEN LLC
Provider Business Mailing Address
First Line : 6380 BELLS FERRY RD STE 107
Second Line :
City : ACWORTH
State : GA
Zip : 30102-5435
Country : US
Telephone Number : 404-989-7384
Fax Number :
Provider Business Practice Location Address
First Line : 6380 BELLS FERRY RD
Second Line :
City : ACWORTH
State : GA
Zip : 30102-5435
Country : US
Telephone Number : 404-989-7384
Fax Number :
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : MS. CHRISTINA ABERNATHY
Credential :
Telephone Number : 678-602-3677
Provider Enumeration Date : 06/24/2020
Last Update Date : 06/24/2020

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Directions to “IRISHMEN LLC ” Practice Location

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