ALFREDIA PRUITT (NPI# 1356658322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356658322 |
| Entity Type | Individual |
| Full Name | ALFREDIA PRUITT |
| Practice Address |
4499 Beacon Hill Dr Sw Lilburn GA 30047-8913 |
| Practice Telephone | 7706683915 |
| Mailing Telephone | 7706683915 |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2017-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| N | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
Suppliers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| N | 376J00000X | Homemaker | Nursing Service Related Providers |
| Street Address |
4499 BEACON HILL DR SW |
| City | LILBURN |
| State | GA |
| Zip Code | 30047-8913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861217 | Latrina S Walden | Nurse Practitioner | 887 Ryan Lane, Lilburn, GA 30047 | 2018-08-15 |
| 1811483928 | Olivia Oyegunle | Optometrist | 4153 Lawrenceville Hwy Nw Ste 5, Lilburn, GA 30047 | 2018-07-02 |
| 1932619285 | Mpm Creative, LLC | Speech-Language Pathologist | 1560 Hewatt Rd, Lilburn, GA 30047 | 2017-10-01 |
| 1528515186 | Smith Dental Care of Lilburn, Inc. | Dentist | 3100 Five Forks Trickham Rd Suite 201, Lilburn, GA 30047 | 2016-09-01 |
| 1891143244 | Choices Behavioral Alternatives | Counselor | 4037 Darling Court, Suite B, Lilburn, GA 30047 | 2016-05-26 |
| 1235595687 | Georgia Dental Associates | Clinic/Center | 3100 Five Forks Trickum Road Suite 201, Lilburn, GA 30047 | 2016-01-14 |
| 1912382144 | Sangeetha Asokan | Dentist | 609, Beaver Ruin Road, Tebo Dental for Kids, Lilburn, GA 30047 | 2015-07-29 |
| 1467836403 | Pamela Neal | Registered Nurse | 3315 Landingview Ct, Lilburn, GA 30047 | 2015-07-18 |
| 1699172452 | Josie Kou, Kulah Curran | Registered Nurse | 3708 Tamer Ln, Lilburn, GA 30047 | 2014-11-21 |
| 1184039380 | Cheryl Lee | Chiropractor | 5014 Stone Mountain Hwy, Suite C, Lilburn, GA 30047 | 2014-06-25 |
| Find all providers in zip 30047 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163228 | Juanetta Barnes | Durable Medical Equipment & Medical Supplies | 2597 Thorngate Way, Acworth, GA 30101-8837 | 2020-08-06 |
| 1952919136 | Aklor Inc | Durable Medical Equipment & Medical Supplies | 2310 Parklake Dr Ne Ste 135, Atlanta, GA 30345-2913 | 2020-07-14 |
| 1285254656 | Kinetic Prosthetics & Medical Supply | Durable Medical Equipment & Medical Supplies | 3595 Hiram Douglasville Hwy Ste 102, Hiram, GA 30141-4963 | 2020-04-25 |
| 1215569843 | Jessi'ca Coley | Durable Medical Equipment & Medical Supplies | 451 Brookview Dr Ste A, Riverdale, GA 30274-7206 | 2020-02-11 |
| 1497387260 | Ogles Oxygen, LLC | Durable Medical Equipment & Medical Supplies | 5901 Goshen Springs Rd Ste G, Norcross, GA 30071-3506 | 2020-02-10 |
| 1982248969 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 4406 Mercer University Drive, Suite D, Macon, GA 31210-5608 | 2019-11-01 |
| 1548816283 | Daniel Arbuckle | Durable Medical Equipment & Medical Supplies | 2304 Pierce Way, Buford, GA 30519-2293 | 2019-08-16 |
| 1700438587 | Evelyn Ray LLC | Durable Medical Equipment & Medical Supplies | 12570 Lakeside Pkwy, Fayetteville, GA 30215-4002 | 2019-07-12 |
| 1073174603 | Freedom Mobility Center, Inc. | Durable Medical Equipment & Medical Supplies | 4717 Us Highway 80 E Ste 7a, Savannah, GA 31410-2943 | 2019-06-25 |
| 1790258226 | Ariana Sade Jones | Durable Medical Equipment & Medical Supplies | 1015 Casa Dr, Clarkston, GA 30021-1109 | 2019-01-08 |
| Find all providers with the same taxonomy | ||||
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| 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.