Provider Demographics
NPI:1679075873
Name:ATLANTA WIDE MOBILE TESTING, LLC
Entity type:Organization
Organization Name:ATLANTA WIDE MOBILE TESTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUJIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-343-0088
Mailing Address - Street 1:2215 CHESHIRE BRIDGE RD NE STE C
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4234
Mailing Address - Country:US
Mailing Address - Phone:404-343-0088
Mailing Address - Fax:877-779-5837
Practice Address - Street 1:2215 CHESHIRE BRIDGE RD NE STE C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4234
Practice Address - Country:US
Practice Address - Phone:404-343-0088
Practice Address - Fax:877-779-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty