Provider Demographics
NPI:1720686058
Name:WORLDWIDE MEDICAL HEALTHCARE INC
Entity Type:Organization
Organization Name:WORLDWIDE MEDICAL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BUKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:O
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-764-3477
Mailing Address - Street 1:950 EAGLES LANDING PKWY # 274
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7343
Mailing Address - Country:US
Mailing Address - Phone:770-389-9116
Mailing Address - Fax:770-506-4580
Practice Address - Street 1:790 CHURCH ST NE STE 300
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8902
Practice Address - Country:US
Practice Address - Phone:770-389-9116
Practice Address - Fax:770-506-4580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA243038113BMedicaid