Healthcare Provider Details

I. General information

NPI: 1679724397
Provider Name (Legal Business Name): R & G COLE ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2483 HERITAGE VLG SUITE 16-238
SNELLVILLE GA
30078-6140
US

IV. Provider business mailing address

2483 HERITAGE VLG SUITE 16-238
SNELLVILLE GA
30078-6140
US

V. Phone/Fax

Practice location:
  • Phone: 404-510-4792
  • Fax: 888-623-3021
Mailing address:
  • Phone: 404-510-4792
  • Fax: 888-623-3021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number1077-7740
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberCN0028898365
License Number StateGA

VIII. Authorized Official

Name: MS. GUILLERMINA OSORIA COLE SR.
Title or Position: CEO
Credential: CNA/PCT
Phone: 404-510-4792