MEDICARE: HICKMAN TAYLOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332U00000X	Home Delivered Meals
3	174200000X	Meals Provider
4	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1356236061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HICKMAN TAYLOR

Provider Business Mailing Address
First Line	:	5596 BLUEGRASS DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-2956
Country	:	US
Telephone Number	:	678-704-6766
Fax Number	:	678-704-6766

Provider Business Practice Location Address
First Line	:	5596 BLUEGRASS DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-2956
Country	:	US
Telephone Number	:	678-704-6766
Fax Number	:	678-704-6766

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LOVICK
Credential	:
Telephone Number	:	678-704-6766

Provider Enumeration Date	:	06/11/2025
Last Update Date	:	06/11/2025

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Directions to “HICKMAN TAYLOR ” Practice Location

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