Healthcare Provider Details

I. General information

NPI: 1689248734
Provider Name (Legal Business Name): PLOI EXCELLENT HEALTHCARE SERVICES L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 BEAR CREEK BLVD STE 102
HAMPTON GA
30228-1816
US

IV. Provider business mailing address

1062 BEAR CREEK BLVD STE 102
HAMPTON GA
30228-1816
US

V. Phone/Fax

Practice location:
  • Phone: 770-510-6107
  • Fax: 866-412-5069
Mailing address:
  • Phone: 770-510-6107
  • Fax: 866-412-5069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IROLDA HARRIS
Title or Position: OWNER
Credential:
Phone: 770-510-6107