De Advance Home Healthcare Services Inc

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

033-R-1270 Issued in GA

Legal business name

DE ADVANCE HOME HEALTHCARE SERVICES INC

Practice address

932 Landon Dr
Marietta, GA 30064-6421

Phone

(678) 559-8132

Fax

(770) 485-5314

NPI assigned

Sep 8, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Ikechukwu Elegede, DIRECTOR

Title

Owner

Phone

(678) 559-8132

Specialties & licenses 1

Addresses

Other names 1

• DE Advance Home Healthcare Services Doing business as

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1164940235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 LANDON DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 LANDON DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300646421",
            "telephone_number": "678-559-8132",
            "fax_number": "770-485-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE ADVANCE HOME HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "ELEGEDE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "IKECHUKWU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-559-8132",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "GA",
            "license": "033-R-1270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DE Advance Home Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community Health Registered Nurse in Marietta, GA
• Providers in Marietta, GA by specialty
• Community Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.