Provider Demographics
NPI:1093259418
Name:OGBEMUDIA, FRANCA
Entity Type:Individual
Prefix:
First Name:FRANCA
Middle Name:
Last Name:OGBEMUDIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 PLANTATION GLEN CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4957
Mailing Address - Country:US
Mailing Address - Phone:404-484-8224
Mailing Address - Fax:
Practice Address - Street 1:235 PLANTATION GLEN CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4957
Practice Address - Country:US
Practice Address - Phone:404-484-8224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-1558253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA060-R-1558OtherPRIVATE HOME CARE PROVIDER