MEDICARE: RNJ OASIS HOMECARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1316514193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RNJ OASIS HOMECARE SERVICES LLC

Provider Business Mailing Address
First Line	:	366 POWDER SPRINGS ST STE 212
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-3424
Country	:	US
Telephone Number	:	678-539-3368
Fax Number	:	912-590-0586

Provider Business Practice Location Address
First Line	:	366 POWDER SPRINGS ST STE 212
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-3424
Country	:	US
Telephone Number	:	678-539-3368
Fax Number	:	912-590-0586

Authorized Official
Title or Position	:	OWNER
Name	:	NARDGEIDA JACQUES
Credential	:
Telephone Number	:	678-539-3368

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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