MEDICARE: SIRIUS HEALTHCARE 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	:	1669300851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIRIUS HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	5761 DEERFIELD TRL
Second Line	:
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-3763
Country	:	US
Telephone Number	:	404-478-7890
Fax Number	:	202-989-0530

Provider Business Practice Location Address
First Line	:	5761 DEERFIELD TRL
Second Line	:
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-3763
Country	:	US
Telephone Number	:	404-478-7890
Fax Number	:	202-989-0530

Authorized Official
Title or Position	:	AUTHORIZED AGENT / OWNER
Name	:	SHAKEYA FRAZIER
Credential	:
Telephone Number	:	678-799-1205

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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Directions to “SIRIUS HEALTHCARE LLC ” Practice Location

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