Provider Demographics
NPI:1376849802
Name:JAMBAH GROUP, LLC
Entity Type:Organization
Organization Name:JAMBAH GROUP, LLC
Other - Org Name:TURNING POINT HEALTH CARE SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:J
Authorized Official - Last Name:PINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-972-0340
Mailing Address - Street 1:2356 LENORA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3233
Mailing Address - Country:US
Mailing Address - Phone:770-972-0340
Mailing Address - Fax:770-972-0379
Practice Address - Street 1:2356 LENORA CHURCH RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3233
Practice Address - Country:US
Practice Address - Phone:770-972-0340
Practice Address - Fax:770-972-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-01
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA063059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA063059OtherLICENSE