Provider Demographics
NPI:1790176907
Name:OPTIMUM HEALTHCARE SOLUTIONS
Entity Type:Organization
Organization Name:OPTIMUM HEALTHCARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-977-8237
Mailing Address - Street 1:245 N. STREET
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30630
Mailing Address - Country:US
Mailing Address - Phone:706-743-3698
Mailing Address - Fax:
Practice Address - Street 1:245 N. STREET
Practice Address - Street 2:
Practice Address - City:CRAWFORD
Practice Address - State:GA
Practice Address - Zip Code:30648
Practice Address - Country:US
Practice Address - Phone:706-743-8639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA65897332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies