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General NPI Number Information
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NPI Number | 1518106343
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Entity Type | Organization
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Legal Business Name | BUFORD HOME CARE,LLC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 09/24/2015
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Provider Practice Location Address
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Address Line | 4420 S LEE ST STE 108
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City | BUFORD
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State | GA
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Zip | 30518-3651
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Country | US
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Telephone | 770-831-8782
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Fax | 770-831-8798
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Provider Business Mailing Address
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Address Line | 4420 S LEE ST STE 108
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City | BUFORD
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State | GA
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Zip | 30518-3651
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Country | US
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Telephone | 770-831-8782
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Fax | 770-831-8798
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GOODDAY URHUOGO
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Credential | RN. BSN
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Telephone | 770-831-8782
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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 | 067-R-0403
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License Number State | GA
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