MEDICARE: GREATER CHOICE CARE 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

General Provider Information

NPI Number	:	1194428615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER CHOICE CARE LLC

Provider Business Mailing Address
First Line	:	3380 PEACHTREE RD NE UNIT 1212
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1650
Country	:	US
Telephone Number	:	470-573-6221
Fax Number	:

Provider Business Practice Location Address
First Line	:	3380 PEACHTREE RD NE UNIT 1212
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1650
Country	:	US
Telephone Number	:	470-573-6221
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	OSAMEDE EGBENUSI
Credential	:
Telephone Number	:	470-573-6221

Provider Enumeration Date	:	03/23/2023
Last Update Date	:	03/23/2023

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