FUSION DIRECT MEDICAL AND WELLNESS NPI 1427729318

NPI Information

NPI: 1427729318
Provider Name: FUSION DIRECT MEDICAL AND WELLNESS
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 11D2261239

Address:
1070 EAGLES LANDING PKWY
STOCKBRIDGE, GA
ZIP 30281
Phone: (679) 718-8403
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FUSION DIRECT MEDICAL AND WELLNESS is a health service clinic center in Stockbridge, GA. FUSION DIRECT MEDICAL AND WELLNESS NPI is 1427729318. The provider is registered as an organization entity type.

The provider's business location address is:

1070 EAGLES LANDING PKWY
STOCKBRIDGE, GA
ZIP 30281-012
Phone: (679) 718-8403

The provider's authorized official is Yudelky Tereza Bentley .
The authorized official title is Practice Owner and has the following contact phone number (470) 878-1246.

The CLIA number assigned to this NPI record is 11D2261239 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2021 and was last updated on 5/3/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251E00000X	Home Health		No
2	261QI0500X	Clinic/Center	Infusion Therapy	No
3	261QH0100X	Clinic/Center	Health Service	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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