Organization
BIVINS ENTERPRISE, LLC
Active
Other names
Bivins Geriatric Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE ELAINE FANNING DNP (PRESIDENT)
(404) 820-0964
Entity
Organization
Contact information
Practice address
30 ROSEMOORE DR, COVINGTON, GA 30014-7065
(404) 820-0964
Mailing address
5486 SOMERSBY PKWY, PINSON, AL 35126-5512
(140) 482-0096
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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