# NOVA MEDICAL SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144784679
- **Authorized official:** RICHARD GLASS JR. (DIRECTOR)
- **Authorized official phone:** (770) 812-3928

## Contact information

- **Practice address:** 20 HERRELL RD, VILLA RICA, GA 30180-5527
- **Practice address phone:** (770) 726-7460
- **Mailing address:** PO BOX 1149, VILLA RICA, GA 30180-6149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/29/2019
- **Last updated:** 10/11/2021