Healthcare Provider Details

I. General information

NPI: 1841170453
Provider Name (Legal Business Name): GOLDEN HOMECARE & MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4854 OLD NATIONAL HWY STE 120
COLLEGE PARK GA
30337-6225
US

IV. Provider business mailing address

4854 OLD NATIONAL HWY STE 120
COLLEGE PARK GA
30337-6225
US

V. Phone/Fax

Practice location:
  • Phone: 678-852-3784
  • Fax:
Mailing address:
  • Phone: 678-852-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. VICTOR EZENWA AMUZIE
Title or Position: OWNER
Credential:
Phone: 678-852-3784