Provider Demographics
NPI:1336921006
Name:HEALTHY USA COMPANY LLC
Entity Type:Organization
Organization Name:HEALTHY USA COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEXANDRIA
Authorized Official - Middle Name:DOMINIQUE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:678-462-6636
Mailing Address - Street 1:PO BOX 55255
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-5255
Mailing Address - Country:US
Mailing Address - Phone:678-462-6636
Mailing Address - Fax:
Practice Address - Street 1:1147 S HAIRSTON RD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30088-2720
Practice Address - Country:US
Practice Address - Phone:404-947-1723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare