Olistell, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

056-R-0004 Issued in GA

Legal business name

OLISTELL, INC.

Doing business as

Southeastern Healthcare Services

Practice address

290 Highway 314
Suite C
Fayetteville, GA 30214-7813

Phone

(770) 719-8454

Fax

(770) 719-2532

NPI assigned

Mar 14, 2006

Last updated

Aug 22, 2020By 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

Mr. Benjamin O. Davies

Title

Ceo

Phone

(770) 719-5229

Specialties & licenses 1

Addresses

Other names 1

• Southeastern Healthcare Services Doing business as

Locations

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841269768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 HIGHWAY 314",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147813",
            "telephone_number": "770-719-8454",
            "fax_number": "770-719-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 HIGHWAY 314",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147813",
            "telephone_number": "770-719-8454",
            "fax_number": "770-719-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLISTELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-719-5229",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "056-R-0004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeastern Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.