MEDICARE: N&S HOLISIC PREMIER HOME CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1184451502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N&S HOLISIC PREMIER HOME CARE

Provider Business Mailing Address
First Line	:	1020 MCDANIEL ST SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-3140
Country	:	US
Telephone Number	:	347-417-1091
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 MCDANIEL ST SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-3140
Country	:	US
Telephone Number	:	347-417-1091
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	NABINTOU BAKAYOKO
Credential	:
Telephone Number	:	347-417-1091

Provider Enumeration Date	:	09/18/2024
Last Update Date	:	09/18/2024

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