MEDICARE: CLOUD HEALTHCARE & WELLNESS SERVICES

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	261QP2300X	Primary Care Clinic/Center	RN150780	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710265392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOUD HEALTHCARE & WELLNESS SERVICES

Provider Business Mailing Address
First Line	:	5388 REUBEN CT
Second Line	:
City	:	ELLENWOOD
State	:	GA
Zip	:	30294-4322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1103 FOREST PKWY
Second Line	:
City	:	FOREST PARK
State	:	GA
Zip	:	30297-2308
Country	:	US
Telephone Number	:	404-883-2376
Fax Number	:

Authorized Official
Title or Position	:	OWNER/NURSE PRACTITIONER
Name	:	ROSEMARY THOMAS-CLOUD
Credential	:
Telephone Number	:	404-883-2376

Provider Enumeration Date	:	07/29/2011
Last Update Date	:	06/19/2013

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