Provider Demographics
NPI:1548751084
Name:AFFORDABLE 1 CARE,LLC,
Entity Type:Organization
Organization Name:AFFORDABLE 1 CARE,LLC,
Other - Org Name:SWAB FOR LIFE CAMPAIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, MARKETING
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMAAL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:877-285-1780
Mailing Address - Street 1:810 WILLOW BEND DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30238-5956
Mailing Address - Country:US
Mailing Address - Phone:404-702-0961
Mailing Address - Fax:
Practice Address - Street 1:706 KING RD STE F
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2034
Practice Address - Country:US
Practice Address - Phone:404-702-0961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare