Provider Demographics
NPI:1912158155
Name:ATENDA OF GEORGIA INC
Entity Type:Organization
Organization Name:ATENDA OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAZAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-217-6055
Mailing Address - Street 1:15712 SW 41ST ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331
Mailing Address - Country:US
Mailing Address - Phone:954-217-6055
Mailing Address - Fax:954-734-2209
Practice Address - Street 1:15712 SW 41ST ST
Practice Address - Street 2:SUITE 16
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33331
Practice Address - Country:US
Practice Address - Phone:954-217-6055
Practice Address - Fax:954-734-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies