Organization
NOVATROSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHILE BANKS (C.E.O)
(404) 337-6994
Entity
Organization
Contact information
Practice address
11175 CICERO DR, ALPHARETTA, GA 30022-1179
(404) 337-6994
Mailing address
13954 SUNFISH BND, ALPHARETTA, GA 30004-0605
(404) 337-6994
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13475453
SECRETARY OF STATE
GA
Enumeration date
01/19/2021
Last updated
01/19/2021
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