Healthcare Provider Details

I. General information

NPI: 1700712726
Provider Name (Legal Business Name): DOMICICARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 WHITFIELD AVE
CUMMING GA
30040-6351
US

IV. Provider business mailing address

3025 WHITFIELD AVE
CUMMING GA
30040-6351
US

V. Phone/Fax

Practice location:
  • Phone: 404-512-0101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: FATOU TOURE
Title or Position: OWNER
Credential:
Phone: 770-875-2627