Provider Demographics
NPI:1083025217
Name:AHMERE HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:AHMERE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERIAL
Authorized Official - Middle Name:LASHAWN
Authorized Official - Last Name:REVELL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:706-322-7606
Mailing Address - Street 1:6801 RIVER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-3352
Mailing Address - Country:US
Mailing Address - Phone:706-322-7606
Mailing Address - Fax:888-970-8674
Practice Address - Street 1:6801 RIVER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3352
Practice Address - Country:US
Practice Address - Phone:706-322-7606
Practice Address - Fax:888-970-8674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service