Provider Demographics
NPI:1235296443
Name:EXECUTIVE HEALTH AND RESEARCH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:EXECUTIVE HEALTH AND RESEARCH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAPO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:404-256-9040
Mailing Address - Street 1:5505 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 650
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1705
Mailing Address - Country:US
Mailing Address - Phone:404-252-0701
Mailing Address - Fax:404-256-2060
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 650
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1705
Practice Address - Country:US
Practice Address - Phone:404-252-0701
Practice Address - Fax:404-256-2060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty