MEDICARE: RETIRE CARE INVESTMENT COMPANY

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	332BN1400X	Nursing Facility Supplies (DME)	3688	GA
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	3688	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457555138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RETIRE CARE INVESTMENT COMPANY

Provider Business Mailing Address
First Line	:	712 PATTERSON ST
Second Line	:
City	:	BYROMVILLE
State	:	GA
Zip	:	31007
Country	:	US
Telephone Number	:	229-268-7510
Fax Number	:	229-268-4716

Provider Business Practice Location Address
First Line	:	712 PATTERSON ST
Second Line	:
City	:	BYROMVILLE
State	:	GA
Zip	:	31007
Country	:	US
Telephone Number	:	229-268-7510
Fax Number	:	229-268-4716

Authorized Official
Title or Position	:	OWNER
Name	:	RICK FALLAW
Credential	:
Telephone Number	:	229-268-7510

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	03/06/2009

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Directions to “RETIRE CARE INVESTMENT COMPANY ” Practice Location

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