Evolution Wellness

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

EVOLUTION WELLNESS

Practice address

2330 Scenic Hwy S
Snellville, GA 30078-3115

Phone

(770) 835-4084

NPI assigned

Sep 24, 2020

Organization subpart

No

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

Authorized official

Name

Chandra Cousin

Title

Ceo

Phone

(757) 831-7931

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1427665348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "770-835-4084",
            "fax_number": "877-811-2952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SCENIC HWY S",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783115",
            "telephone_number": "770-835-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "COUSIN",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-831-7931"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eniquah Kahlelah Etienne, BS
• Angel Eto, MSW
• Gizelle Evan, RBT
• Corey Evont Evans, M.A. CCC-SLP
• Evergreen Medical Supply Inc
• Executive Home Care Services, LLC
• Extended Grace Counseling, LLC
• Extraordinary Family Healthcare
• Kaitlyn Eyer
• James Fabricant, RBT

• Durable Medical Equipment & Medical Supplies in Snellville, GA
• Providers in Snellville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.