Organization
LOTUS GROUP LLC
Active
Organization
LOTUS GROUP LLC
Active
Other names
ReNew Infusion & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LETHENIA JOY BAKER MD (MEDICAL DIRECTOR)
(706) 577-2883
Entity
Organization
Contact information
Practice address
1605 VERNON RD STE 1600, LAGRANGE, GA 30240-4166
(706) 577-2883
Mailing address
1605 VERNON RD STE 1600, LAGRANGE, GA 30240-4166
(706) 577-2883
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
163WG0000X
General Practice Registered Nurse
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
202D00000X
Integrative Medicine Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135520
—
GA
Enumeration date
06/21/2023
Last updated
06/21/2023
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