Provider Demographics
NPI:1912561259
Name:CONCIERGE MEDICAL SERVICES
Entity Type:Organization
Organization Name:CONCIERGE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:JABLONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:205-250-8523
Mailing Address - Street 1:394 VININGS VINTAGE CIR
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-7238
Mailing Address - Country:US
Mailing Address - Phone:205-250-9966
Mailing Address - Fax:888-265-5564
Practice Address - Street 1:394 VININGS VINTAGE CIR
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-7238
Practice Address - Country:US
Practice Address - Phone:205-250-9966
Practice Address - Fax:888-265-5564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty