Provider Demographics
NPI:1669163085
Name:EVENTS TRAVEL STATION
Entity type:Organization
Organization Name:EVENTS TRAVEL STATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:GWENETTA
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-330-7109
Mailing Address - Street 1:305 BROOKHAVEN AVE NE UNIT 458
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3271
Mailing Address - Country:US
Mailing Address - Phone:404-330-7109
Mailing Address - Fax:
Practice Address - Street 1:305 BROOKHAVEN AVE NE UNIT 458
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-3271
Practice Address - Country:US
Practice Address - Phone:404-330-7109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management