Provider Demographics
NPI:1578907283
Name:ZENIA 1 LLC
Entity Type:Organization
Organization Name:ZENIA 1 LLC
Other - Org Name:SUGARLOAF URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-575-2863
Mailing Address - Street 1:4835 SUGARLOAF PARKWAY
Mailing Address - Street 2:SUITE 200/300
Mailing Address - City:LAWRENCEILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044
Mailing Address - Country:US
Mailing Address - Phone:770-334-7474
Mailing Address - Fax:800-513-4431
Practice Address - Street 1:4835 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 200/300
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-6912
Practice Address - Country:US
Practice Address - Phone:770-334-7474
Practice Address - Fax:800-513-4431
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZENIA1 LLC DBA SUGARLOAF URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-24
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024690261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care