MEDICARE: SAVI NUTRITION

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1174221352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVI NUTRITION

Provider Business Mailing Address
First Line	:	3650 ASHFORD DUNWOODY RD NE UNIT 1023
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-2065
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 ASHFORD DUNWOODY RD NE UNIT 1023
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-2065
Country	:	US
Telephone Number	:	770-539-5805
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SARA KHAN
Credential	:
Telephone Number	:	404-421-0064

Provider Enumeration Date	:	02/17/2023
Last Update Date	:	02/17/2023

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