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General NPI Number Information
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NPI Number | 1841096591
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Entity Type | Organization
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Legal Business Name | ANCHOR HOME CARE SERVICE LLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 2330 CAPE COURAGE WAY
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City | SUWANEE
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State | GA
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Zip | 30024-2796
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Country | US
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Telephone | 706-491-5339
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 CAPE COURAGE WAY
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City | SUWANEE
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State | GA
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Zip | 30024-2796
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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 | CHIEF EXECUTIVE OFFICER (CEO)
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Name | RUSUL JADDOA OTHMAN
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Credential |
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Telephone | 706-491-5339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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