MEDICARE: EXCELCARE HEALTH SERVICES

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	163WH0200X	Home Health Registered Nurse	RN179142	GA

General Provider Information

NPI Number	:	1124223284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELCARE HEALTH SERVICES

Provider Business Mailing Address
First Line	:	3200 SHAKERAG HL
Second Line	:	SUITE B
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-6511
Country	:	US
Telephone Number	:	678-902-0200
Fax Number	:	678-902-0201

Provider Business Practice Location Address
First Line	:	3200 SHAKERAG HL
Second Line	:	SUITE B
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-6511
Country	:	US
Telephone Number	:	678-902-0200
Fax Number	:	678-902-0201

Authorized Official
Title or Position	:	CHIEF NURSING OFFICER
Name	:	MRS. ANGELLA FRANCIS
Credential	:	RN
Telephone Number	:	678-902-0200

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	08/22/2020

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