=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386563310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE PLUG CARE SUPPORT SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2026
-----------------------------------------------------
Last Update Date | 07/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 257 ERMINES WAY
-----------------------------------------------------
City | MCDONOUGH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30253-7485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-855-9516
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 257 ERMINES WAY
-----------------------------------------------------
City | MCDONOUGH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30253-7485
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-855-9516
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROGRAM DIRECTOR/CEO
-----------------------------------------------------
Name | TARMEKA TOLBERT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 470-855-9516
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171M00000X
-----------------------------------------------------
Taxonomy Name | Case Manager/Care Coordinator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------