Mofazzal Suraiya LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

067-R-0459 Issued in GA

Legal business name

MOFAZZAL SURAIYA LLC

Practice address

2775 Cruse Rd Ste 101
Lawrenceville, GA 30044-7141

Phone

(404) 587-8500

Fax

(770) 939-5682

NPI assigned

Nov 5, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Jamil Imran

Title

President

Phone

(404) 587-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• m and s homecare services Doing business as

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.

• Mofazzal Suraiya LLC

  • Home Health Agency
  • Norcross, GA
  • NPI 1447558010
  NPD tax ID

Locations

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1962703082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 CRUSE RD STE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300447141",
            "telephone_number": "404-587-8500",
            "fax_number": "770-939-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOFAZZAL SURAIYA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "IMRAN",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-587-8500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "067-R-0459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221998235A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "m and s homecare services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Modern Therapy
• Haresh Modha, D.D.S.
• Andrea Peyton Moe, PA
• Melanie Michelle Moebes
• Tim Scott Moeckel, D.C.
• Mog Vision Center Inc
• Adrian Mark Mogos, MD
• Heval Mohamed Kelli, M.D.
• Halima Mohamed, NP
• Mustafa Mohammed Salih, MD

• In Home Supportive Care Agency in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.