Provider Demographics
NPI:1548496987
Name:PENNY HEALTH SERVICES
Entity type:Organization
Organization Name:PENNY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNINAH
Authorized Official - Middle Name:N
Authorized Official - Last Name:NDUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-933-4139
Mailing Address - Street 1:3061 ELMENDORF LN NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7426
Mailing Address - Country:US
Mailing Address - Phone:678-933-4139
Mailing Address - Fax:678-574-6930
Practice Address - Street 1:3061 ELMENDORF LN NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7426
Practice Address - Country:US
Practice Address - Phone:678-933-4139
Practice Address - Fax:678-574-6930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0421253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care