Healthcare Provider Details

I. General information

NPI: 1497665327
Provider Name (Legal Business Name): PRETTY IN PINK HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 RIVERSIDE DR STE 180
MACON GA
31204-1747
US

IV. Provider business mailing address

2124 RIVERSIDE DR STE 180
MACON GA
31204-1747
US

V. Phone/Fax

Practice location:
  • Phone: 470-428-6527
  • Fax:
Mailing address:
  • Phone: 470-428-6527
  • 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: SHAYONDA RENAE LOCKHART
Title or Position: ADMINISTRATOR
Credential:
Phone: 470-428-6527