Lucky Addeh
Individual provider Active NPI Home Health Agency · Powder Springs, GA
NPI 1154960672 · NPPES record last updated Dec 31, 2019
Key facts
- NPI
- 1154960672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- License
- PHCP010445 (GA)
- Practice address
- 1440 Paddocks CT
Powder Springs, GA 30127-5514 - Phone
- (404) 932-3511
- NPI assigned
- Dec 31, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHCP010445 | GA | MD | Home Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | PHCP010445 | GA | Yes |
Addresses
Primary practice location
1440 Paddocks CT
Powder Springs, GA 30127-5514
Mailing address
1440 Paddocks CT
Powder Springs, GA 30127-5514
Phone (404) 932-3511
Other providers in Powder Springs, GA
- 3460 Powder Springs Road Associates, L.P.
- A1 Diagnostics LLC
- Lukman Adekunle Adebayo
- Adenike O Adeyanju
- Adk Powder Springs Operator, LLC
- Advance Care Medical Georgia, Inc.
- Advance Care Medical PCP Georgia, Inc.
All providers in Powder Springs, GA · Home Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.