Provider Demographics
NPI:1134971732
Name:MD3 HEALTHCARE SYSTEMS LLC
Entity type:Organization
Organization Name:MD3 HEALTHCARE SYSTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEIRDDRE
Authorized Official - Middle Name:LYNNELL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-422-9290
Mailing Address - Street 1:3648 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-1432
Mailing Address - Country:US
Mailing Address - Phone:678-756-6376
Mailing Address - Fax:
Practice Address - Street 1:2342 MARYLAND CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-6136
Practice Address - Country:US
Practice Address - Phone:678-221-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care