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NPI Code Detail

MEDICARE: OVERFLOW NATION LLC

MEDICARE: OVERFLOW NATION 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
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1972446151
Entity Type Code : Organization
Provider Name (Legal Business Name) : OVERFLOW NATION LLC
Provider Business Mailing Address
First Line : 313 STONEY HOLLOW RD
Second Line :
City : CANTON
State : GA
Zip : 30114-7245
Country : US
Telephone Number : 404-907-1918
Fax Number :
Provider Business Practice Location Address
First Line : 313 STONEY HOLLOW RD
Second Line :
City : CANTON
State : GA
Zip : 30114-7245
Country : US
Telephone Number : 404-907-1918
Fax Number :
Authorized Official
Title or Position : FOUNDER/PRESIDENT
Name : BILLY FOWLER
Credential : FOWLER
Telephone Number : 630-670-8888
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “OVERFLOW NATION LLC ” Practice Location

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