Preventive Care Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PREVENTIVE CARE SERVICES, INC.

Practice address

3961 Floyd Rd # 300335
Austell, GA 30106-8535

Phone

(770) 319-8201

Fax

(770) 234-3890

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Cheryl Regina Eaves, RN

Title

Ceo/President

Phone

(770) 319-8201

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1245453620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 FLOYD RD # 300335",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068535",
            "telephone_number": "770-319-8201",
            "fax_number": "770-234-3890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 FLOYD RD # 300335",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068535",
            "telephone_number": "770-319-8201",
            "fax_number": "770-234-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "EAVES",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "770-319-8201",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653573A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H445131",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.