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General NPI Number Information
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NPI Number | 1376241398
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Entity Type | Organization
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Legal Business Name | HOMELINK AETNA GEORGIA
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 1111 W SAN MARNAN DR
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City | WATERLOO
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State | IA
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Zip | 50701-8927
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Country | US
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Telephone | 800-642-6065
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1860
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City | WATERLOO
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State | IA
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Zip | 50704-1860
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP, COMPLIANCE & ACCREDITATION
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Name | DAVID HARBERTS
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Credential |
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Telephone | 855-875-6140
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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 |
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License Number State |
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Taxonomy #2
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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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