MEDICARE: ADORATION HOME HEALTH CARE GEORGIA, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1255151890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADORATION HOME HEALTH CARE GEORGIA, LLC

Provider Business Mailing Address
First Line	:	805 N WHITTINGTON PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-7101
Country	:	US
Telephone Number	:	502-394-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 GREEN CIR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-2734
Country	:	US
Telephone Number	:	229-253-1242
Fax Number	:

Authorized Official
Title or Position	:	MANAGER & VICE PRESIDENT
Name	:	MARGARET SHERRY PEMBERTON
Credential	:
Telephone Number	:	502-394-2100

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	10/16/2024

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