Provider Demographics
NPI:1104177427
Name:BETHESDA HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BETHESDA HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REUBEN
Authorized Official - Middle Name:IKEME
Authorized Official - Last Name:ONWUZURUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-219-3444
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30081-0792
Mailing Address - Country:US
Mailing Address - Phone:770-222-9995
Mailing Address - Fax:678-401-8285
Practice Address - Street 1:2692 CANDLER DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4263
Practice Address - Country:US
Practice Address - Phone:770-222-9995
Practice Address - Fax:678-401-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care