Provider Demographics
NPI:1679005011
Name:CHADON HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:CHADON HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AZUKA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ONYEMELUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-575-0547
Mailing Address - Street 1:6298 BROOKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5378
Mailing Address - Country:US
Mailing Address - Phone:770-575-0547
Mailing Address - Fax:
Practice Address - Street 1:2180 SATELITE BLVD
Practice Address - Street 2:STE 400
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097
Practice Address - Country:US
Practice Address - Phone:770-575-0547
Practice Address - Fax:404-420-2139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-1525251E00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No302R00000XManaged Care OrganizationsHealth Maintenance Organization