Healthcare Provider Details

I. General information

NPI: 1427366590
Provider Name (Legal Business Name): SECURE CARE AUGUSTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 MONTE SANO AVE
AUGUSTA GA
30904-7808
US

IV. Provider business mailing address

1520 MONTE SANO AVE
AUGUSTA GA
30904-7808
US

V. Phone/Fax

Practice location:
  • Phone: 706-993-9271
  • Fax:
Mailing address:
  • Phone: 706-993-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: TARA LEGRAND LUNDY
Title or Position: BILLING MANAGER
Credential:
Phone: 706-723-9926