Healthcare Provider Details

I. General information

NPI: 1740638436
Provider Name (Legal Business Name): RELIANCE HEALTH AND HOME PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 CARVER RD
GRIFFIN GA
30224-3937
US

IV. Provider business mailing address

PO BOX 1454
GRIFFIN GA
30224-0034
US

V. Phone/Fax

Practice location:
  • Phone: 770-227-9222
  • Fax: 770-227-9009
Mailing address:
  • Phone: 770-227-9222
  • Fax: 770-227-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: TAMMIE STEWARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 678-953-3528