Provider Demographics
NPI:1114176484
Name:ASSURED HEALTH LLC
Entity type:Organization
Organization Name:ASSURED HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:H
Authorized Official - Last Name:BACCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-760-0296
Mailing Address - Street 1:3379 PEACHTREE RD NE
Mailing Address - Street 2:STE 330
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1031
Mailing Address - Country:US
Mailing Address - Phone:404-760-0296
Mailing Address - Fax:
Practice Address - Street 1:2999 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-4226
Practice Address - Country:US
Practice Address - Phone:404-760-0296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care