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General NPI Number Information
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NPI Number | 1275762742
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/06/2009
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 1572 HIGHWAY 85 N STE 338
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7729
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Country | US
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Telephone | 678-519-5593
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Fax | 678-519-5674
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Provider Business Mailing Address
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Address Line | 1572 HIGHWAY 85 N STE 338
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7729
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Country | US
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Telephone | 678-519-5593
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Fax | 678-519-5674
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELLE ELIZABETH BASS
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Credential |
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Telephone | 678-519-5593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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