Provider Demographics
NPI:1932811197
Name:EN GEDI RX, LLC
Entity type:Organization
Organization Name:EN GEDI RX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:GREENSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-210-1478
Mailing Address - Street 1:135 WEATHERFORD PLACE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075
Mailing Address - Country:US
Mailing Address - Phone:404-210-1478
Mailing Address - Fax:888-375-3346
Practice Address - Street 1:135 WEATHERFORD PLACE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075
Practice Address - Country:US
Practice Address - Phone:404-210-1478
Practice Address - Fax:888-375-3346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management