MEDICARE: HOST MANAGEMENT COMPANY, INC.

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	332BC3200X	Customized Equipment (DME)	301083553	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	:	1912903501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOST MANAGEMENT COMPANY, INC.

Provider Business Mailing Address
First Line	:	1093 MEADOW BROOK DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-6563
Country	:	US
Telephone Number	:	770-778-2431
Fax Number	:	706-233-8277

Provider Business Practice Location Address
First Line	:	1093 MEADOW BROOK DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-6563
Country	:	US
Telephone Number	:	770-778-2431
Fax Number	:	706-233-8277

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RODNEY SINCLAIR COLVER
Credential	:
Telephone Number	:	770-778-2431

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/23/2013

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Directions to “HOST MANAGEMENT COMPANY, INC. ” Practice Location

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