Organization · NPI-2

Active Life Health Of Lilburn LLC

Durable Medical Equipment & Medical Supplies · Lilburn, GA

NPI number1295404531
StatusActive
Last updated in NPPESNov 9, 2021

Details

NPI
1295404531
Entity type
Organization (NPI-2)
Legal business name
Active Life Health Of Lilburn LLC
Organization subpart
No
Enumeration date
Sep 9, 2021
Certification date
Nov 9, 2021
Last updated
Nov 9, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies––Yes

Other names

  • Arthritis Knee Pain Centers (Doing Business As)

Practice location

629 Beaver Ruin Rd Nw Ste B
Lilburn, GA 30047-3437

Phone 770-755-1515 · Fax 770-370-8173

Mailing address

629 Beaver Ruin Rd Nw Ste B
Lilburn, GA 30047-3437

Phone 770-755-1515 · Fax 770-370-8173

Authorized official

John J Rush
Chairman & Chief Executive Officer
7707551515

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Durable Medical Equipment & Medical Supplies providers in Lilburn, GA