NPIMap

Organization Active NPI

Arkangels Homecare Services

  • Durable Medical Equipment & Medical Supplies
  • Jonesboro, GA
National Provider Identifier
1316195712
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
031 R 0040 Issued in GA
Legal business name
ARKANGELS HOMECARE SERVICES
Practice address
9411 S Main St
Ste-D
Jonesboro, GA 30236-8705
Phone
(770) 477-4755
Fax
(770) 477-4758
NPI assigned
Aug 28, 2008
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ARKANGELS HOMECARE SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Mrs. Benedeteh U Moh
Title
Administrator
Phone
(770) 477-4755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 031 R 0040 GA Primary

Addresses

Primary practice location

9411 S Main St
Ste-D
Jonesboro, GA 30236-8705

Mailing address

9411 S Main St
Ste-D
Jonesboro, GA 30236-8705
Phone (770) 477-4755

Other identifiers 1

IdentifierTypeStateIssuer
457729570DMedicaidGA

National Provider Directory

National Provider Directory
Part of
Arkangels Homecare Services

Locations

9411 S Main St
Jonesboro, GA 30236
Phone (770) 477-4755

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1316195712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 S MAIN ST",
            "address_2": "STE-D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368705",
            "telephone_number": "770-477-4755",
            "fax_number": "770-477-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 S MAIN ST",
            "address_2": "STE-D",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368705",
            "telephone_number": "770-477-4755",
            "fax_number": "770-477-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANGELS HOMECARE SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARKANGELS HOMECARE SERVICES",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "MOH",
        "authorized_official_first_name": "BENEDETEH",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-477-4755",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "031 R 0040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "457729570D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.