Basic Information
| Provider Information | |||||||||
| NPI: | 1750647194 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | METNURSE HEALTH SERVICES, INC. | ||||||||
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| OtherOrganizationName: | MHS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 WESTRIDGE PKWY | ||||||||
| Address2: | SUITE 221 | ||||||||
| City: | MCDONOUGH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302533049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6786947180 | ||||||||
| FaxNumber: | 8558744592 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 WESTRIDGE PKWY | ||||||||
| Address2: | SUITE 221 | ||||||||
| City: | MCDONOUGH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302533049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6786947180 | ||||||||
| FaxNumber: | 8558744592 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2012 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| AuthorizedOfficialLastName: | OKWUADIGBO | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | U | ||||||||
| AuthorizedOfficialTitleorPosition: | ASSISTANT ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6786947180 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PHD. | ||||||||
| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 320900000X | N | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 332BX2000X | 075-R-0969 | GA | N | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | 251E00000X | 075-R-0969 | GA | Y | Agencies | Home Health |
No ID Information.