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NPI Code Detail

MEDICARE: MATRIA HEALTHCARE, INC.

MEDICARE: MATRIA HEALTHCARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
171020000Q00005OTHERMIBC BS OF MI PROVIDER NUM.

General Provider Information

NPI Number : 1255495214
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATRIA HEALTHCARE, INC.
Provider Business Mailing Address
First Line : 1850 PARKWAY PL SE
Second Line : ATTN REIMBURSEMENT
City : MARIETTA
State : GA
Zip : 30067-4439
Country : US
Telephone Number : 770-767-4999
Fax Number : 770-767-7420
Provider Business Practice Location Address
First Line : 1850 PARKWAY PL SE
Second Line : ATTN REIMBURSEMENT
City : MARIETTA
State : GA
Zip : 30067-4439
Country : US
Telephone Number : 770-767-4999
Fax Number : 770-767-7420
Authorized Official
Title or Position : CHAIRMAN OF THE BOARD
Name : MR. PARKER H. PETIT
Credential :
Telephone Number : 770-767-4600
Provider Enumeration Date : 12/21/2006
Last Update Date : 04/20/2008

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Directions to “MATRIA HEALTHCARE, INC. ” Practice Location

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