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NPI Code Detail

MEDICARE: JOY AGBOOLA

MEDICARE:   JOY  AGBOOLA
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1659926996
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY AGBOOLA
Provider Business Mailing Address
First Line : 2341 CHEROKEE VALLEY CIR
Second Line :
City : LITHONIA
State : GA
Zip : 30058-5383
Country : US
Telephone Number : 347-654-7922
Fax Number :
Provider Business Practice Location Address
First Line : 2341 CHEROKEE VALLEY CIR
Second Line :
City : LITHONIA
State : GA
Zip : 30058-5383
Country : US
Telephone Number : 347-654-7922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2019
Last Update Date : 02/26/2020

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Directions to “ JOY AGBOOLA ” Practice Location

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