Provider Demographics
NPI:1285259846
Name:MESUN HEALTH SERVICES, INC
Entity type:Organization
Organization Name:MESUN HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:T
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-599-8107
Mailing Address - Street 1:88 JOHNSON RD BUILDING # 1-B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046
Mailing Address - Country:US
Mailing Address - Phone:770-623-2710
Mailing Address - Fax:770-623-2711
Practice Address - Street 1:88 JOHNSON RD BUILDING # 1-B
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:770-623-2710
Practice Address - Fax:770-623-2711
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MESUN HEALTH SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-10
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty