NPI Profile for ALFREDIA PRUITT in LILBURN, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Dialysis Equipment & Supplies |
332BD1200X | 87 | All Other Suppliers | |
Home Health Aide |
374U00000X | |||
Homemaker |
376J00000X |
| NPI # | 1356658322 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/10/2010 | |
| Last updated | 02/08/2017 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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ALFREDIA PRUITT
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