Provider Demographics
NPI:1124312269
Name:JONES, ALMEDA (DIRECTOR)
Entity type:Individual
Prefix:MRS
First Name:ALMEDA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:DIRECTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-5288
Mailing Address - Country:US
Mailing Address - Phone:770-786-4044
Mailing Address - Fax:770-786-4044
Practice Address - Street 1:600 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-5288
Practice Address - Country:US
Practice Address - Phone:770-786-4044
Practice Address - Fax:770-786-4044
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA107-01-024-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA788699715BMedicaid