# LONGER LIFE SERVICES OF GA CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1760662902
- **Authorized official:** PABLO SANU (PRESIDENT)
- **Authorized official phone:** (404) 438-1293

## Contact information

- **Practice address:** 1025 ROSE CREEK DR, SUITE 620-173, WOODSTOCK, GA 30189-6797
- **Practice address phone:** (404) 438-1293
- **Mailing address:** 1025 ROSE CREEK DR, SUITE 620-173, WOODSTOCK, GA 30189-6797
- **Mailing address phone:** (404) 438-1293

## Taxonomy

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

## Other

- **Enumeration date:** 11/05/2007
- **Last updated:** 11/05/2007