OrganizationActive
Community Based Healthcare Services
NPI 1316389901 · Preferred Provider Organization · Tucker, GA
Provider details
- NPI number
- 1316389901
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Derrick Boswell, Director(678) 964-7107
Specialties & taxonomies
Managed Care Organizations
Practice location
2374 Main St Ste B
Tucker, GA 30084-4533
Phone: (678) 964-7107
Approximate (ZIP-level) locationGet directions
Mailing address
2374 Main St Ste B
Tucker, GA 30084-4533
Registry dates
- Enumerated
- 2013-07-23
- Last updated
- 2013-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.