Provider Demographics
NPI:1245609007
Name:CHEMON HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CHEMON HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBUZIEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-656-8967
Mailing Address - Street 1:2701 WINSLEY DR SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5714
Mailing Address - Country:US
Mailing Address - Phone:770-656-8967
Mailing Address - Fax:770-659-2738
Practice Address - Street 1:2701 WINSLEY DR SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5714
Practice Address - Country:US
Practice Address - Phone:770-702-1927
Practice Address - Fax:770-659-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-1231251J00000X
033-R-1231253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care