Provider Demographics
NPI:1851153373
Name:MORTUARY ARTISTS, INC.
Entity Type:Organization
Organization Name:MORTUARY ARTISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/BCC CHAPLAIN
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-964-3066
Mailing Address - Street 1:5701 MABLETON PKWY SW STE 108
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-3357
Mailing Address - Country:US
Mailing Address - Phone:470-964-3066
Mailing Address - Fax:470-964-3066
Practice Address - Street 1:5701 MABLETON PKWY SW STE 108
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-3357
Practice Address - Country:US
Practice Address - Phone:470-964-3066
Practice Address - Fax:470-964-3066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty