Provider Demographics
NPI:1386874576
Name:GEORGIA HEALTHIER SOLUTIONS, LLC
Entity type:Organization
Organization Name:GEORGIA HEALTHIER SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:Q
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-766-4633
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-0006
Mailing Address - Country:US
Mailing Address - Phone:404-766-4633
Mailing Address - Fax:404-766-1108
Practice Address - Street 1:1029 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-6719
Practice Address - Country:US
Practice Address - Phone:404-766-4633
Practice Address - Fax:404-766-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039644261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11D0260723OtherCLIA ID
GA989123085AMedicaid
GA11BDLTMOtherMEDICARE PROVIDER #
GA202G709719OtherMEDICARE PTAN
GAG44062Medicare UPIN