Provider Demographics
NPI:1174659809
Name:NUTRITION MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:NUTRITION MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LD
Authorized Official - Phone:706-563-5783
Mailing Address - Street 1:PO BOX 5532
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-0532
Mailing Address - Country:US
Mailing Address - Phone:706-563-5783
Mailing Address - Fax:706-561-5838
Practice Address - Street 1:3025 UNIVERSITY AVE
Practice Address - Street 2:SUITE C-1
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-2101
Practice Address - Country:US
Practice Address - Phone:706-563-5783
Practice Address - Fax:706-561-5838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD000095133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4905Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER