Provider Demographics
NPI:1477818490
Name:OHM CLINICAL SERVICES, INC.
Entity Type:Organization
Organization Name:OHM CLINICAL SERVICES, INC.
Other - Org Name:CAREPLUS BUFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-926-8599
Mailing Address - Street 1:8100B ROSWELL RD
Mailing Address - Street 2:400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2033 BUFORD HWY
Practice Address - Street 2:109
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8802
Practice Address - Country:US
Practice Address - Phone:404-865-1228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHM CLINICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty