Healthcare Provider Details

I. General information

NPI: 1942248331
Provider Name (Legal Business Name): PRUITTHEALTH HOME HEALTH - SOUTH ATLANTA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 RED OAK ROAD BUILDING 25
UNION CITY GA
30291-2391
US

IV. Provider business mailing address

1626 JEURGENS COURT LEGAL DEPT
NORCROSS GA
30093-2219
US

V. Phone/Fax

Practice location:
  • Phone: 770-254-8573
  • Fax: 770-306-1032
Mailing address:
  • Phone: 770-279-6200
  • Fax: 770-931-5278

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: NEIL L PRUITT JR.
Title or Position: CHAIRMAN AND CEO
Credential:
Phone: 770-279-6200