Provider Demographics
NPI:1194473926
Name:A ONE HEALTH CARE GEORGIA LLC
Entity Type:Organization
Organization Name:A ONE HEALTH CARE GEORGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AJIROGHENE
Authorized Official - Middle Name:S
Authorized Official - Last Name:OMANUDHOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-876-4573
Mailing Address - Street 1:3500 BROOKSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-6534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3500 BROOKSTONE WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-6534
Practice Address - Country:US
Practice Address - Phone:770-876-4573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health