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Organization

SAFEWAY HEALTHCARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BENSON NOSA AGBONAVBARE (ADMINISTRATOR)
(770) 255-9500
Entity
Organization

Contact information

Practice address
3846 WOOD HOLLOW WAY, SNELLVILLE, GA 30039-6080
(770) 255-9500
(770) 733-1329
Mailing address
2386 CLOWER STREET, BUILDING C, SUITE 209, SNELLVILLE, GA 30078-6108
(770) 255-9500
(770) 733-1329

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
44-R-0203
GA

Other

Enumeration date
05/12/2009
Last updated
06/09/2015
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