MEDICARE: GOLDEN RULE HOME 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	253Z00000X	In Home Supportive Care Agency	121-R-0625	GA

General Provider Information

NPI Number	:	1922397181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN RULE HOME CARE AGENCY, LLC

Provider Business Mailing Address
First Line	:	2918 PROFESSIONAL PKWY
Second Line	:	SUITE 212
City	:	AUGUSTA
State	:	GA
Zip	:	30907-3593
Country	:	US
Telephone Number	:	707-650-7020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2918 PROFESSIONAL PKWY
Second Line	:	SUITE 212
City	:	AUGUSTA
State	:	GA
Zip	:	30907-3593
Country	:	US
Telephone Number	:	706-650-7020
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MISS ELLEN TAYLOR
Credential	:
Telephone Number	:	707-650-7020

Provider Enumeration Date	:	03/28/2011
Last Update Date	:	03/28/2011

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