Provider Demographics
NPI:1437802188
Name:PURPOSEFUL HEALTH & LAB SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PURPOSEFUL HEALTH & LAB SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACKERY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:770-703-6979
Mailing Address - Street 1:1115 MOUNT ZION RD STE 10
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2241
Mailing Address - Country:US
Mailing Address - Phone:770-917-2570
Mailing Address - Fax:
Practice Address - Street 1:1115 MOUNT ZION RD STE 10
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2241
Practice Address - Country:US
Practice Address - Phone:770-917-2570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty