MEDICARE: AMARE HEALTH SOLUTIONS 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
1	291U00000X	Clinical Medical Laboratory
2	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1083368773
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMARE HEALTH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3037 SHADOW WALK LN
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-2140
Country	:	US
Telephone Number	:	678-368-3361
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 NORTHLAKE PKWY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2204
Country	:	US
Telephone Number	:	404-454-0719
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHIQUITA L WHITE
Credential	:
Telephone Number	:	404-454-0719

Provider Enumeration Date	:	02/10/2022
Last Update Date	:	02/10/2022

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