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NPI Code Detail

MEDICARE: GEORGIA HOUSECALLS, LLC

MEDICARE: GEORGIA HOUSECALLS, 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
1251E00000XHome Health Agency004135GA
2251E00000XHome Health Agency039684GA

General Provider Information

NPI Number : 1679725022
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEORGIA HOUSECALLS, LLC
Provider Business Mailing Address
First Line : 2020 HOWELL MILL RD NW
Second Line : STE 168
City : ATLANTA
State : GA
Zip : 30318-1732
Country : US
Telephone Number : 404-790-0911
Fax Number :
Provider Business Practice Location Address
First Line : 2020 HOWELL MILL RD NW
Second Line : STE 168
City : ATLANTA
State : GA
Zip : 30318-1732
Country : US
Telephone Number : 404-790-0911
Fax Number :
Authorized Official
Title or Position : PARTNER 49
Name : YVONNE DOLORES WICKS
Credential : PA
Telephone Number : 404-790-0911
Provider Enumeration Date : 10/16/2008
Last Update Date : 10/16/2008

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Directions to “GEORGIA HOUSECALLS, LLC ” Practice Location

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