NPIMap

Organization Active NPI

Mofazzal Suraiya LLC

  • Home Health Agency
  • Norcross, GA
National Provider Identifier
1447558010
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MOFAZZAL SURAIYA LLC
Practice address
1015 Omaha Dr
Norcross, GA 30093-4967
Phone
(404) 587-8500
Fax
(770) 939-5682
NPI assigned
Mar 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Authorized official

Name
Jamil Imran, M.D.
Title
Owner
Phone
(404) 587-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1015 Omaha Dr
Norcross, GA 30093-4967

Mailing address

2775 Cruse Rd
Suite 101
Lawrenceville, GA 30044-7140
Phone (404) 587-8500

National Provider Directory

National Provider Directory
Tax ID family
M and S Homecare Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1447558010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 CRUSE RD",
            "address_2": "SUITE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447140",
            "telephone_number": "404-587-8500",
            "fax_number": "770-939-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 OMAHA DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300934967",
            "telephone_number": "404-587-8500",
            "fax_number": "770-939-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOFAZZAL SURAIYA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "IMRAN",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-587-8500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.