Healthcare Provider Details

I. General information

NPI: 1669236089
Provider Name (Legal Business Name): ROVE HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 JOHN WESLEY DOBBS AVE NE UNIT C
ATLANTA GA
30312-1669
US

IV. Provider business mailing address

500 SAWGRASS VW
FAIRBURN GA
30213-2884
US

V. Phone/Fax

Practice location:
  • Phone: 404-500-0129
  • Fax: 770-779-7723
Mailing address:
  • Phone: 140-455-8531
  • Fax: 770-779-7723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code246QH0000X
TaxonomyHematology Specialist/Technologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: TAMHRA ROBERSON
Title or Position: MANAGER
Credential:
Phone: 404-500-0129