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General NPI Number Information
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NPI Number | 1326438086
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Entity Type | Organization
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Legal Business Name | UNITED HOME CARE SERVICES,LLC
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 1122 GRAY HIGHWAY
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City | MACON
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State | GA
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Zip | 31211
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Country | US
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Telephone | 478-305-7338
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 GRAY HWY
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City | MACON
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State | GA
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Zip | 31211-1869
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Country | US
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Telephone | 478-305-7338
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARKCHARLES OGUNJIOFOR
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Credential |
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Telephone | 770-846-5602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 011-R-1360
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License Number State | GA
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