GRACEOL CORPORATION


Address: 1035 Honey Creek Rd, Conyers, GA 30013
Phone: 4048392688

GRACEOL CORPORATION (NPI# 1306373188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306373188
Entity Type Organization
Organization Name GRACEOL CORPORATION
Practice Address 1035 Honey Creek Rd
Conyers
GA 30013
Mailing Address 1035 Honey Creek Road
Conyers
GA 30013
Practice Telephone 4048392688
Practice Fax Number 7709229498
Mailing Telephone (404) 839-2688
Mailing Fax Number 7709229498
Enumeration Date 2017-05-11
Last Update Date 2017-06-29
Authorized Official Name MRS. YEMI J. SOWEMIMO (OWNER)
Authorized Official Telephone 4048392688
Authorized Official Credential FNP-C
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0505X Family Medicine
Specialization: Adult Medicine
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
GA NPI 1790107381 01
GA NPI 1639177066 01
NY NPI 1912016411 01

Office Location

Street Address 1035 HONEY CREEK RD
City CONYERS
State GA
Zip Code 30013

Providers in the same zip code

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1043735244 Niki Tanyell Davis Licensed Practical Nurse 1403 Windy Hill Court, Conyers, GA 30013 2017-08-08
1063941490 Comprehensive Health and Rehab LLC Clinic/Center 2500 Riverton Drive, Conyers, GA 30013 2017-06-08
1881149268 Jsa Dental Associates Conyers PC Dentist 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 2016-08-16
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Taxonomy Information

Taxonomy Code 207QA0505X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Adult Medicine

Taxonomy Definition

Definition to come.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245241975 Arlene Annetta Lewis Family Medicine 1383 Manchester Dr Ne Ste B, Conyers, GA 30012 2006-08-10
1235626003 Andrea A Rose Family Medicine 2796 Highway 20 Se, Conyers, GA 30013-2735 2018-04-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1306464250 Leah Reed Family Medicine 2082 Cherokee Farms Cv, Buford, GA 30519-7004 2020-07-08
1083240766 Carehere LLC Family Medicine 114 N Jackson St, Albany, GA 31701-2583 2020-03-13
1518590744 Octavia Raquel Holloway-freeman Family Medicine 301 Denmark St, Statesboro, GA 30458-5208 2020-02-17
1891331575 Jenna Barnes Family Medicine 1107 Memorial Dr Ste 300, Dalton, GA 30720-8664 2019-11-18
1023651205 Carehere LLC Family Medicine 750 S Perry St Ste 200, Lawrenceville, GA 30046-4804 2019-10-21
1003385733 James G Hamilton Jr Md LLC Family Medicine 4898 Highway 197, Mount Airy, GA 30563-2442 2018-11-26
1780161323 Personal Wellness Inc. Family Medicine 625 Boxwood Ter, Johns Creek, GA 30005-7217 2018-07-26
1073005138 Lake Oconee Wellness Associates LLC Family Medicine 1097 Lake Oconee Pkwy Ste 201, Eatonton, GA 31024-9510 2018-06-05
1376034983 Lee Pennington Mcnichols Family Medicine 2300 Bethelview Rd Ste 110-332, Cumming, GA 30040-9475 2018-05-21
1972021301 Docpecox, LLC Family Medicine 755 Mount Vernon Hwy Ne Ste 350, Atlanta, GA 30328-4291 2017-09-06
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Competitor

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City CONYERS
Zip Code 30013

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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