Provider Demographics
NPI:1447696786
Name:ATHERIUM HEALTHCARE LLC
Entity type:Organization
Organization Name:ATHERIUM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:JUAN
Authorized Official - Last Name:ANAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:678-690-5296
Mailing Address - Street 1:1755 N BROWN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8198
Mailing Address - Country:US
Mailing Address - Phone:678-690-5296
Mailing Address - Fax:888-473-7096
Practice Address - Street 1:1755 N BROWN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-8198
Practice Address - Country:US
Practice Address - Phone:678-690-5296
Practice Address - Fax:888-473-7096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
No253Z00000XAgenciesIn Home Supportive Care