Provider Demographics
NPI:1619605672
Name:ABSOLUTECARE OF OHIO, LLC
Entity Type:Organization
Organization Name:ABSOLUTECARE OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-738-0225
Mailing Address - Street 1:PO BOX 2273
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-1688
Mailing Address - Country:US
Mailing Address - Phone:404-231-4431
Mailing Address - Fax:
Practice Address - Street 1:7580 NORTHCLIFF AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3270
Practice Address - Country:US
Practice Address - Phone:404-231-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty