Healthcare Provider Details

I. General information

NPI: 1336811504
Provider Name (Legal Business Name): GEORGIA-LINA HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 FLOYD AVE
NORTH AUGUSTA SC
29841-4276
US

IV. Provider business mailing address

120 FLOYD AVE
NORTH AUGUSTA SC
29841-4276
US

V. Phone/Fax

Practice location:
  • Phone: 803-426-8071
  • Fax: 803-426-8144
Mailing address:
  • Phone: 803-426-8071
  • Fax: 803-426-8144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MARTRINO DENISE GODLEY
Title or Position: OWNER
Credential: RN
Phone: 706-373-4454