Healthcare Provider Details

I. General information

NPI: 1245955681
Provider Name (Legal Business Name): BAKER 4 INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2022
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2813 HAMILTON RD
COLUMBUS GA
31904-8738
US

IV. Provider business mailing address

2813 HAMILTON RD
COLUMBUS GA
31904-8738
US

V. Phone/Fax

Practice location:
  • Phone: 706-987-8600
  • Fax: 706-987-8601
Mailing address:
  • Phone: 706-987-8600
  • Fax: 706-987-8601

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

VIII. Authorized Official

Name: MRS. SHARON BAKER
Title or Position: FRANCHISE OWNER
Credential: REGISTERED NURSE
Phone: 706-987-8600