MEDICARE: JD HEALTHCARE SERVICES 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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1265111520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JD HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	316 MEGAN DR
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-4858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 MEGAN DR
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-4858
Country	:	US
Telephone Number	:	470-526-5606
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DWIGHT HARRIS
Credential	:
Telephone Number	:	470-526-5606

Provider Enumeration Date	:	07/13/2023
Last Update Date	:	07/13/2023

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