Healthcare Provider Details

I. General information

NPI: 1538168414
Provider Name (Legal Business Name): HOME MEDICAL PROFESSIONALS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2344 CHAMBLEE TUCKER RD
CHAMBLEE GA
30341-3447
US

IV. Provider business mailing address

1655 OAKBROOK DR SUITE B
GAINESVILLE GA
30507-8492
US

V. Phone/Fax

Practice location:
  • Phone: 678-547-0619
  • Fax:
Mailing address:
  • Phone: 770-533-9404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00738174B
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer

VIII. Authorized Official

Name: MR. ERIC PARKHILL
Title or Position: VICE-PRESIDENT
Credential:
Phone: 770-533-9404