Provider Demographics
NPI:1912692674
Name:INX HEALTHCARE
Entity Type:Organization
Organization Name:INX HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONIE
Authorized Official - Middle Name:TAMARA
Authorized Official - Last Name:HEWLING
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:770-695-1206
Mailing Address - Street 1:588 VILLAGE RUN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5078
Mailing Address - Country:US
Mailing Address - Phone:770-695-1206
Mailing Address - Fax:
Practice Address - Street 1:267 LANGLEY DR # 1008
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6907
Practice Address - Country:US
Practice Address - Phone:770-695-1206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service