Provider Demographics
NPI:1457542557
Name:MOSTHOUSE INC
Entity type:Organization
Organization Name:MOSTHOUSE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:TURKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-432-9755
Mailing Address - Street 1:3201 S COBB DR SE
Mailing Address - Street 2:STE. D1
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4115
Mailing Address - Country:US
Mailing Address - Phone:770-432-9755
Mailing Address - Fax:770-432-9757
Practice Address - Street 1:3201 S COBB DR SE
Practice Address - Street 2:STE. D1
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4115
Practice Address - Country:US
Practice Address - Phone:770-432-9755
Practice Address - Fax:770-432-9757
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOSTHOUSE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA06052SC291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory