1891142469 NPI number — NORTH GEORGIA HOME CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891142469 NPI number — NORTH GEORGIA HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH GEORGIA HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SYNERGY HOMECARE OF NORTH GEORGIA
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891142469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2550 HAMILTON MILL RD
Provider Second Line Business Mailing Address:
#600
Provider Business Mailing Address City Name:
BUFORD
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30519-3611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-783-2323
Provider Business Mailing Address Fax Number:
770-872-0913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2550 HAMILTON MILL RD
Provider Second Line Business Practice Location Address:
#600
Provider Business Practice Location Address City Name:
BUFORD
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30519-3611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-783-2323
Provider Business Practice Location Address Fax Number:
770-872-0913
Provider Enumeration Date:
05/24/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ARMSTEAD
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
770-783-2323

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , with the licence number:  067-R-0723 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 253Z00000X , with the licence number: 008-R-0722 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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