Provider Demographics
NPI:1932772423
Name:ESHCOL HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:ESHCOL HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-419-1040
Mailing Address - Street 1:1169 LEYBOURNE CV
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-3573
Mailing Address - Country:US
Mailing Address - Phone:470-419-1040
Mailing Address - Fax:
Practice Address - Street 1:1169 LEYBOURNE CV
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-3573
Practice Address - Country:US
Practice Address - Phone:470-419-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty