Organization · NPI-2

123 Ga Home Heathcare Lllp

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

NPI number1609690312
StatusActive
Last updated in NPPESNov 9, 2024

Details

NPI
1609690312
Entity type
Organization (NPI-2)
Legal business name
123 Ga Home Heathcare Lllp
Organization subpart
No
Enumeration date
Nov 9, 2024
Certification date
Nov 9, 2024
Last updated
Nov 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
343900000X Non-emergency Medical Transport (VAN)––Yes

Other names

  • 123 Ga Home Healthcare (Former Legal Business Name)

Practice location

767 North Ave
Jonesboro, GA 30236-2232

Phone 678-846-9557

Mailing address

767 North Ave
Jonesboro, GA 30236-2232

Phone 678-846-9557

Authorized official

Derrick Whisby
Executive Director
4705546864

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