Provider Demographics
NPI:1851759096
Name:ON-SITE HEALTH SOLUTIONS OF ATLANTA, LLC
Entity Type:Organization
Organization Name:ON-SITE HEALTH SOLUTIONS OF ATLANTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:AUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPIM
Authorized Official - Phone:678-373-4406
Mailing Address - Street 1:1585 OLD NORCROSS RD
Mailing Address - Street 2:102
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4055
Mailing Address - Country:US
Mailing Address - Phone:678-373-4406
Mailing Address - Fax:770-828-0646
Practice Address - Street 1:1585 OLD NORCROSS RD
Practice Address - Street 2:102
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4055
Practice Address - Country:US
Practice Address - Phone:678-373-4406
Practice Address - Fax:770-828-0646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty