ZA1603 LC NPI 1649130311

NPI Information

  • NPI: 1649130311
  • Provider Name: ZA1603 LC
  • Classification: Point of Service - 305S00000X
  • Entity Type: Organization
  • Address: 1824 HERRINGBONE HOLW
    LITHONIA, GA
    ZIP 30058
  • Phone: (470) 486-9860

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NPI Details

ZA1603 LC is a point of service in Lithonia, GA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. ZA1603 LC NPI is 1649130311. The provider is registered as an organization entity type.

The provider's business location address is:

1824 HERRINGBONE HOLW
LITHONIA, GA
ZIP 30058-516
Phone: (470) 486-9860

The provider's authorized official is Dashna Louis-charles .
The authorized official title is Clinician Specialist and has the following contact phone number (470) 486-9860.

The enumeration date for this NPI number is 11/14/2025 and was last updated on 11/14/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305S00000XPoint of ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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