Healthcare Provider Details

I. General information

NPI: 1447282066
Provider Name (Legal Business Name): TALLAPOOSA HOME CARE CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 CAMBRIDGE SQ STE A
ALPHARETTA GA
30009-1869
US

IV. Provider business mailing address

1031 CAMBRIDGE SQ STE A
ALPHARETTA GA
30009-1869
US

V. Phone/Fax

Practice location:
  • Phone: 770-574-9126
  • Fax: 888-501-6340
Mailing address:
  • Phone: 770-574-9126
  • Fax: 888-501-6340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES ANTHONY SMITH
Title or Position: OWNER/C.O.O
Credential: C.O., L.O.
Phone: 404-538-5921