Provider Demographics
NPI:1740579762
Name:UNIVITA HEALTHCARE SOLUTIONS OF GEORGIA, INC
Entity Type:Organization
Organization Name:UNIVITA HEALTHCARE SOLUTIONS OF GEORGIA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUCHNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-333-1000
Mailing Address - Street 1:15800 SW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4222
Mailing Address - Country:US
Mailing Address - Phone:954-333-1027
Mailing Address - Fax:
Practice Address - Street 1:15800 SW 25TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4222
Practice Address - Country:US
Practice Address - Phone:954-333-1027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies