Provider Demographics
NPI:1750909339
Name:SAEREM HEALTHCARE LLC
Entity type:Organization
Organization Name:SAEREM HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLAWUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUN-SEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:425-659-5073
Mailing Address - Street 1:11815 NORTHFALL LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7973
Mailing Address - Country:US
Mailing Address - Phone:425-659-5073
Mailing Address - Fax:
Practice Address - Street 1:11815 NORTHFALL LN
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7973
Practice Address - Country:US
Practice Address - Phone:425-659-5073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)