Provider Demographics
NPI:1477915999
Name:ABC HEALTH
Entity Type:Organization
Organization Name:ABC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:UPSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-345-3135
Mailing Address - Street 1:2075 ANDERSON DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5809
Mailing Address - Country:US
Mailing Address - Phone:404-345-3135
Mailing Address - Fax:770-234-3890
Practice Address - Street 1:7894 WINCHESTER RD
Practice Address - Street 2:STE 500
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-2398
Practice Address - Country:US
Practice Address - Phone:404-345-3135
Practice Address - Fax:770-234-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN66139253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care