Provider Demographics
NPI:1346411170
Name:EM HEARING AND SCREENING
Entity Type:Organization
Organization Name:EM HEARING AND SCREENING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:FABRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-396-5560
Mailing Address - Street 1:2777 JEFFERSON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-4054
Mailing Address - Country:US
Mailing Address - Phone:404-396-5560
Mailing Address - Fax:678-567-2906
Practice Address - Street 1:2777 JEFFERSON ST STE 4
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-4054
Practice Address - Country:US
Practice Address - Phone:404-396-5560
Practice Address - Fax:678-567-2906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAUD003646251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare