Healthcare Provider Details

I. General information

NPI: 1417350695
Provider Name (Legal Business Name): OGR HOME CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 FAIRLEIGH ST
CHATTANOOGA TN
37406-2507
US

IV. Provider business mailing address

2314 FAIRLEIGH ST
CHATTANOOGA TN
37406-2507
US

V. Phone/Fax

Practice location:
  • Phone: 423-309-2845
  • Fax: 423-309-2845
Mailing address:
  • Phone: 423-309-2845
  • Fax: 423-309-2845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROCKSAND MARTIN
Title or Position: OWNER/ DIRECTOR
Credential:
Phone: 423-309-2851