Provider Demographics
NPI:1457604381
Name:SENIOR CARE PLUS LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:SENIOR CARE PLUS LIMITED LIABILITY COMPANY
Other - Org Name:SENIOR CARE PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRPICH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-475-1400
Mailing Address - Street 1:990 PEACHTREE INDUSTRIAL BLVD UNIT 4532
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5249
Mailing Address - Country:US
Mailing Address - Phone:678-475-1400
Mailing Address - Fax:
Practice Address - Street 1:990 PEACHTREE INDUSTRIAL BLVD NUMBER 4532
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5249
Practice Address - Country:US
Practice Address - Phone:678-475-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054904207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty