Active Life Health of Alpharetta LLC
Organization Active NPI Durable Medical Equipment & Medical Supplies · Alpharetta, GA
NPI 1265101596 · NPPES record last updated Feb 4, 2022
Key facts
- NPI
- 1265101596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- ACTIVE LIFE HEALTH OF ALPHARETTA LLC
- Practice address
- 4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478 - Phone
- (770) 755-1771
- Fax
- (770) 370-8140
- NPI assigned
- Sep 9, 2021
- Organization subpart
- No
Authorized official
- Name
- John J Rush, MD
- Title
- Chairman & Chief Executive Officer
- Phone
- (770) 755-1771
Other NPIs with the same Medicare PAC ID 1
Practitioners 9
-
John S Harrison III, PA-C
-
Abieyuwa Eweka, M.D.
-
Keerthi D Prasad, M.D.
-
John J Rush, MD
-
Ruben Diaz, MD
-
Joanne Wu, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220624002057 | GA | DME Supplier - Physician - General Practice | 4880082817 | Practice locations: Alpharetta, GA |
National Provider Directory
Locations
4165 Old Milton Pkwy
Ste 200
Alpharetta, GA 30005
Phone (678) 921-7007
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478
Mailing address
4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478
Phone (770) 755-1771
Other names
- ARTHRITIS KNEE PAIN CENTERS
Other providers in Alpharetta, GA
- Accessway Mobility Services LLC
- Margaret Renee Acker
- Scott M Acker
- Active 4 Life Chiropractic, LLC.
- Active Ankle and Foot Care Specialists
- Active Life Health of Alpharetta LLC
- Acu at Alpharetta LLC
- Acute Health Services, Inc.
- Carolyn A Adams
- Delise Elizabeth Adams
All providers in Alpharetta, GA · Durable Medical Equipment & Medical Supplies in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.