LIFEQUEST EAST MARIETTA LLC (NPI# 1023424181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023424181 |
| Entity Type | Organization |
| Organization Name | LIFEQUEST EAST MARIETTA LLC |
| Other Organization Name | ENERGY MEDICAL GROUP |
| Practice Address |
4930 Davidson Rd Ne 100 Marietta GA 30068-4661 |
| Mailing Address |
3362 Acworth Summit Blvd Nw Acworth GA 30101-5770 |
| Practice Telephone | 6789730635 |
| Mailing Telephone | 6789730635 |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2014-07-09 |
| Authorized Official Name | JAMES BROUSSARD (VICE PRESIDENT) |
| Authorized Official Telephone | 6789730635 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
33753 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Energy Medical Group | Doing Business As Name - Organization |
| Street Address |
4930 DAVIDSON RD NE 100 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30068-4661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798917 | Barbara Ann Goldschmidt | Pharmacist | 4088 Lower Roswell Rd, Marietta, GA 30068 | 2020-10-20 |
| 1285274480 | Cory Plasker | Chiropractor | 519b Johnson Ferry Road, Suite 350, Marietta, GA 30068 | 2020-01-15 |
| 1952949893 | Dr Amy L Varner LLC | Internal Medicine | 1000 Johnson Ferry Rd Bldg E Ste 200, Marietta, GA 30068 | 2019-12-11 |
| 1417501834 | Cornerstone Hospice and Palliative Care of Georgia, LLC | Hospice Care, Community Based | 1225 Johnson Ferry Rd., Bldg. 100, Suite 160, Marietta, GA 30068 | 2019-07-25 |
| 1639721038 | Cayla Clark | Behavior Technician | 137 Johnson Ferry Road Suite 2170, Marietta, GA 30068 | 2019-07-15 |
| 1467910828 | 2me Healthcare,llc | Home Health | 2586 Club Valley Drive Ne, Marietta, GA 30068 | 2019-03-05 |
| 1265912604 | Feidy Chiropractic Clinic Inc, Dba Cardwell Chiropractic Clinic | Chiropractor | 1230 Johnson Ferry Pl Ste G30, Marietta, GA 30068 | 2018-08-15 |
| 1225514219 | Audrey Hughes. Lcsw, LLC | Clinic/Center | 1212 Johnson Ferry Rd, Suite 300, Marietta, GA 30068 | 2018-07-13 |
| 1316461379 | Evan King | Registered Nurse | 52 Pioneer Trl, Marietta, GA 30068 | 2017-08-01 |
| 1912431867 | Anthony Izore | Nurse Practitioner | 5163 Tall Oak Drive, Marietta, GA 30068 | 2017-04-18 |
| Find all providers in zip 30068 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1780048330 | Cheerful Habits LLC | Clinic/Center | 2470 Windy Hill Rd Se, Suite 300 Pmb 5202, Marietta, GA 30067-8613 | 2016-04-11 |
| 1073993150 | Annette Mary Bernard Md P.a. | Clinic/Center | 2470 Windy Hill Rd Se, Num 366c, Marietta, GA 30067-8613 | 2015-06-04 |
| 1366821365 | Professional Premium Services Inc | Clinic/Center | 2470 Windy Hill Rd Se, Num 366c, Marietta, GA 30067-8613 | 2015-05-22 |
| 1144659830 | Radiance Light Systems, LLC | Clinic/Center | 2145 Roswell Rd, Marietta, GA 30062-0821 | 2013-11-04 |
| 1346366747 | P & J Enterprises of West Atl, Inc. | Clinic/Center | 114 Cherry St Ne, Suite C, Marietta, GA 30060-7277 | 2007-03-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.