Healthcare Provider Details

I. General information

NPI: 1447232798
Provider Name (Legal Business Name): WARE VISITING NURSES SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 BRANTLEY ST
NAHUNTA GA
31553-5063
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 912-462-6773
  • Fax: 912-496-5776
Mailing address:
  • Phone: 337-233-1307
  • Fax: 334-443-4154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier00240083E
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerSOURCE
# 2
Identifier000240083A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 3
Identifier000240083B
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerCCSP

VIII. Authorized Official

Name: MR. JOSHUA L PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307