MEDICARE: OUTCOMES HEALTH CONNECTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1407196819	OTHER		NPI

General Provider Information

NPI Number	:	1053737296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUTCOMES HEALTH CONNECTIONS, LLC

Provider Business Mailing Address
First Line	:	13010 MORRIS RD
Second Line	:	BUILDING TWO
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-3873
Country	:	US
Telephone Number	:	404-713-2526
Fax Number	:

Provider Business Practice Location Address
First Line	:	13010 MORRIS RD
Second Line	:	BUILDING TWO
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-3873
Country	:	US
Telephone Number	:	404-713-2526
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	MR. JEFFREY RYAN JONES
Credential	:	MBA, JD
Telephone Number	:	404-713-2526

Provider Enumeration Date	:	03/12/2014
Last Update Date	:	03/12/2014

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