Healthcare Provider Details

I. General information

NPI: 1750015137
Provider Name (Legal Business Name): J & S HOMECARE PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3473 SATELLITE BLVD STE N212
DULUTH GA
30096-8690
US

IV. Provider business mailing address

5633 BRENDLYNN DR
SUWANEE GA
30024-7660
US

V. Phone/Fax

Practice location:
  • Phone: 770-880-7738
  • Fax: 678-606-2377
Mailing address:
  • Phone: 770-880-7738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SEONG HO AN
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 770-880-7738