MEDICARE: NRS2000

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	302F00000X	Exclusive Provider Organization

General Provider Information

NPI Number	:	1932536000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NRS2000

Provider Business Mailing Address
First Line	:	1813 WEE KIRK RD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-4435
Country	:	US
Telephone Number	:	770-912-6446
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 WEE KIRK RD SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-4435
Country	:	US
Telephone Number	:	770-912-6446
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/CEO
Name	:	MS. CAROLINE MARIE WILLIAMS
Credential	:	B.A., M.S., CRC,
Telephone Number	:	770-912-6446

Provider Enumeration Date	:	10/03/2013
Last Update Date	:	10/03/2013

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