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General NPI Number Information
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NPI Number | 1831066158
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Entity Type | Organization
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Legal Business Name | 2540 HOMECARE LLC
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Dates
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Enumeration Date | 10/21/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 160 GREENCASTLE RD STE D
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City | TYRONE
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State | GA
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Zip | 30290-2953
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Country | US
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Telephone | 404-999-2540
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Fax |
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Provider Business Mailing Address
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Address Line | 315 BELAIRE WAY
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City | FAIRBURN
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State | GA
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Zip | 30213-2651
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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 | MANAGING DIRECTOR
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Name | MARCUS T WATKINS
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Credential |
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Telephone | 860-719-9537
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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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