Provider Demographics
NPI:1154472850
Name:INDEPENDENT HEALTH SOLUTIONS, INC.
Entity Type:Organization
Organization Name:INDEPENDENT HEALTH SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:770-252-4750
Mailing Address - Street 1:287 MILLARD FARMER IND BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263
Mailing Address - Country:US
Mailing Address - Phone:770-252-4750
Mailing Address - Fax:770-252-4751
Practice Address - Street 1:287 MILLARD FARMER IND BLVD
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263
Practice Address - Country:US
Practice Address - Phone:770-252-4750
Practice Address - Fax:770-252-4751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00937901AMedicaid
GA4706690001Medicare ID - Type Unspecified