Surestick Lab & Hydration Services

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SURESTICK LAB & HYDRATION SERVICES

Practice address

101 Beckett LN Ste 505
Fayetteville, GA 30214-7160

Phone

(470) 729-0166

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Melinda Harris, RNNPI 1225643257

Title

RN/Ceo

Phone

(708) 692-4646

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melinda Harris, BSN, RN

  • Registered Nurse
  • Fayetteville, GA
  • NPI 1225643257
  NPD Authorized official

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1306430467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10809 LEES CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302387870",
            "telephone_number": "708-692-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BECKETT LN STE 505",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147160",
            "telephone_number": "470-729-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESTICK LAB & HYDRATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "RN/CEO",
        "authorized_official_telephone_number": "708-692-4646",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.