MEDICARE: HEART 2 HOME HEALTH CARE AGENCY LLC

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
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1518786425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART 2 HOME HEALTH CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	3100 GENTIAN BLVD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5670
Country	:	US
Telephone Number	:	706-573-5123
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 GENTIAN BLVD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5670
Country	:	US
Telephone Number	:	706-573-5123
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASMINE POWELL
Credential	:
Telephone Number	:	706-573-5123

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	10/08/2024

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