MEDICARE: FOR THE LOVE OF HEALTH INC

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	207RI0200X	Infectious Disease Physician

General Provider Information

NPI Number	:	1164097515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOR THE LOVE OF HEALTH INC

Provider Business Mailing Address
First Line	:	6595 ROSWELL RD STE G-2387
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3152
Country	:	US
Telephone Number	:	800-450-7310
Fax Number	:	800-450-7310

Provider Business Practice Location Address
First Line	:	3941 OLD ATLANTA STATION DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-1984
Country	:	US
Telephone Number	:	800-450-7310
Fax Number	:	800-450-7310

Authorized Official
Title or Position	:	OWNER
Name	:	COURTNEY HARRING
Credential	:
Telephone Number	:	800-450-7310

Provider Enumeration Date	:	05/26/2021
Last Update Date	:	05/26/2021

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