Prestige Home Care Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

060-R-1530 Issued in GA

Legal business name

PRESTIGE HOME CARE AGENCY

Practice address

1810 Winding Crossing TRL
Fairburn, GA 30213-1275

Phone

(678) 436-3494

Fax

(678) 436-3472

NPI assigned

Feb 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gertrude Wilkinson, RN

Title

Manager

Phone

(678) 436-3494

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1144688284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 WINDING CROSSING TRL",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131275",
            "telephone_number": "678-436-3494",
            "fax_number": "678-436-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 WINDING CROSSING TRL",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302131275",
            "telephone_number": "678-436-3494",
            "fax_number": "678-436-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE HOME CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "GERTRUDE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-436-3494",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "060-R-1530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.