Healthcare Provider Details

I. General information

NPI: 1629396908
Provider Name (Legal Business Name): PM3 OUTSOURCING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 PARKER RD SE STE C210
CONYERS GA
30094-6676
US

IV. Provider business mailing address

174 ODYSSEY TURN
CONYERS GA
30012-3680
US

V. Phone/Fax

Practice location:
  • Phone: 770-376-7190
  • Fax:
Mailing address:
  • Phone: 713-679-1053
  • 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 StateTX
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MISS SHANTELLA LATRESA ROSS
Title or Position: CEO OWNER
Credential:
Phone: 713-679-1053