Provider Demographics
NPI:1477869931
Name:GEORGIA HEALTH & WELLNESS CORPORATION
Entity Type:Organization
Organization Name:GEORGIA HEALTH & WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOHTY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BURBARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-941-2690
Mailing Address - Street 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4111
Mailing Address - Country:US
Mailing Address - Phone:404-941-2690
Mailing Address - Fax:404-941-2698
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:SUITE 304
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4111
Practice Address - Country:US
Practice Address - Phone:404-941-2690
Practice Address - Fax:404-941-2698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty