Organization
THE MEDI GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LANE (DIRECTOR OF ADMINISTRATION)
77063385550
Entity
Organization
Contact information
Practice address
1257 COMMERCIAL DR SW STE B, CONYERS, GA 30094-5991
(770) 483-6393
Mailing address
1257 COMMERCIAL DR SW STE B, CONYERS, GA 30094-5991
(770) 483-6393
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
543734780
—
GA
Enumeration date
01/06/2014
Last updated
01/06/2014
About Stedi
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