Provider Demographics
NPI:1023864386
Name:EMPOWERING MEDICAL GROUP LLC
Entity type:Organization
Organization Name:EMPOWERING MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-852-1333
Mailing Address - Street 1:3994 VILLA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5051
Mailing Address - Country:US
Mailing Address - Phone:404-852-1333
Mailing Address - Fax:678-840-3887
Practice Address - Street 1:1314 CHATTAHOOCHEE AVE NW # C-1
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2829
Practice Address - Country:US
Practice Address - Phone:404-852-1333
Practice Address - Fax:678-840-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health