Provider Demographics
NPI:1558405852
Name:PRIORITY HEALTH PLUS CARE,INC
Entity Type:Organization
Organization Name:PRIORITY HEALTH PLUS CARE,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHNETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-526-7777
Mailing Address - Street 1:8120 MALL PKWY
Mailing Address - Street 2:415
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2597
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8120 MALL PKWY
Practice Address - Street 2:415
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2597
Practice Address - Country:US
Practice Address - Phone:678-526-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies