MEDICARE: SISTERLOVE INCORPORATED

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
1	261Q00000X	Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1083351100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SISTERLOVE INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 10558
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-0558
Country	:	US
Telephone Number	:	404-254-4734
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 RALPH DAVID ABERNATHY BLVD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-1731
Country	:	US
Telephone Number	:	404-505-7777
Fax Number	:	404-505-0003

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MS. KAREEN T SCOTT
Credential	:
Telephone Number	:	917-549-1457

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	03/25/2026

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Directions to “SISTERLOVE INCORPORATED ” Practice Location

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