Earth Bar LLC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Legal business name

EARTH BAR LLC

Practice address

2855 Tobacco Rd Ste D
Hephzibah, GA 30815-7197

Phone

(706) 941-2302

NPI assigned

Feb 15, 2023

Last updated

Feb 15, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Uniqua Clemons, CHHP

Title

Owner

Phone

(706) 941-2302

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1003513524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 TOBACCO RD STE D",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157197",
            "telephone_number": "706-941-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TOBACCO RD STE D",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157197",
            "telephone_number": "706-941-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH BAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "CLEMONS",
        "authorized_official_first_name": "UNIQUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-941-2302",
        "authorized_official_credential": "CHHP"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health & Wellness Coach in Hephzibah, GA
• Providers in Hephzibah, GA by specialty
• Health & Wellness Coach in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.