Provider Demographics
NPI:1811597461
Name:NANORESEARCH, INC
Entity Type:Organization
Organization Name:NANORESEARCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DIT
Authorized Official - Phone:404-717-3559
Mailing Address - Street 1:58 EDGEWOOD AVE NE,
Mailing Address - Street 2:SUITE 122, COLLABTECH., GSU
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-940-3925
Mailing Address - Fax:
Practice Address - Street 1:58 EDGEWOOD AVE NE,
Practice Address - Street 2:SUITE 122, COLLABTECH., GSU
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-940-3925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NANORESEARCH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11D2190652OtherCENTERS FOR MEDICARE AND MEDICAID SERVICES