MEDICARE: ADVIR HEALTH CARE SYSTEMS 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1568901395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVIR HEALTH CARE SYSTEMS LLC

Provider Business Mailing Address
First Line	:	3851 LINCOLN JONES RD STE B
Second Line	:
City	:	ELLENWOOD
State	:	GA
Zip	:	30294-1828
Country	:	US
Telephone Number	:	404-829-2682
Fax Number	:	404-228-3064

Provider Business Practice Location Address
First Line	:	3851 LINCOLN JONES RD STE B
Second Line	:
City	:	ELLENWOOD
State	:	GA
Zip	:	30294-1828
Country	:	US
Telephone Number	:	404-829-2682
Fax Number	:	404-228-3064

Authorized Official
Title or Position	:	OWNER
Name	:	ARTHUR L WASHINGTON
Credential	:
Telephone Number	:	404-829-2682

Provider Enumeration Date	:	02/13/2017
Last Update Date	:	03/13/2017

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