Provider Demographics
NPI:1922698281
Name:ELINA HEALTH MANAGEMENT LLC
Entity Type:Organization
Organization Name:ELINA HEALTH MANAGEMENT LLC
Other - Org Name:PEACHTREE URGENT CARE AND FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGAWABRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-859-7809
Mailing Address - Street 1:5380 PEACHTREE INDUSTRIAL BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-1565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5380 PEACHTREE INDUSTRIAL BLVD STE 150
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1565
Practice Address - Country:US
Practice Address - Phone:470-275-4911
Practice Address - Fax:470-545-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty