Organization · NPI-2

123 Ga Home Healthcare, Lllp

Non-emergency Medical Transport (VAN) · Jonesboro, GA

NPI number1285480962

StatusActive

Last updated in NPPESSep 17, 2026

Details

NPI: 1285480962
Entity type: Organization (NPI-2)
Legal business name: 123 Ga Home Healthcare, Lllp
Organization subpart: No
Enumeration date: Apr 24, 2024
Certification date: Apr 24, 2024
Last updated: Sep 17, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
343900000X	Non-emergency Medical Transport (VAN)	–	–	Yes
251E00000X	Home Health	–	–
251F00000X	Home Infusion	–	–
251G00000X	Hospice Care, Community Based	–	–
251J00000X	Nursing Care	–	–
251S00000X	Community/Behavioral Health	–	–
385H00000X	Respite Care	–	–

Other names

123 Ga Home Healthcare (Doing Business As)

Practice location

767 North Ave
Jonesboro, GA 30236-2232

Phone 678-304-2118 · Fax 478-202-9464

Mailing address

767 North Ave
Jonesboro, GA 30236-2232

Phone 678-304-2118 · Fax 478-202-9464

Authorized official

Derrick Whisby
Ceo
4705546864

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