Provider Demographics
NPI:1235514167
Name:SPRINT SERVICES
Entity Type:Organization
Organization Name:SPRINT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AALEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-957-9629
Mailing Address - Street 1:5061 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3108
Mailing Address - Country:US
Mailing Address - Phone:404-567-6688
Mailing Address - Fax:404-909-8180
Practice Address - Street 1:5061 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3108
Practice Address - Country:US
Practice Address - Phone:404-567-6688
Practice Address - Fax:404-909-8180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare