Healthcare Provider Details

I. General information

NPI: 1487029559
Provider Name (Legal Business Name): APPLE A DAY HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 12/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ABERNATHY RD SUITE 1700
ATLANTA GA
30328-5662
US

IV. Provider business mailing address

1200 ABERNATHY RD SUITE 1700
ATLANTA GA
30328-5662
US

V. Phone/Fax

Practice location:
  • Phone: 770-350-2627
  • Fax: 770-551-8105
Mailing address:
  • Phone: 770-350-2627
  • Fax: 770-551-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number060-R-1429
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: WYTERIA MACK
Title or Position: CO-OWNER
Credential:
Phone: 770-350-2627