Southcare Medical & Homecare Service
Organization Active NPI Home Health Agency · Vienna, GA
NPI 1366764185 · NPPES record last updated Mar 10, 2023
Key facts
- NPI
- 1366764185
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 046-R-0644 (GA)
- Legal business name
- SOUTHCARE MEDICAL & HOMECARE SERVICE
- Practice address
- 1303 E Union St Ste a
Vienna, GA 31092-7540 - Phone
- (404) 844-9975
- Fax
- (888) 687-4829
- NPI assigned
- Feb 21, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. George Echebelem
- Title
- Operating Manager
- Phone
- (404) 844-9975
National Provider Directory
Locations
1150 Industrial Dr
Ste 142
Vienna, GA 31092
1303 E Union St
Ste A
Vienna, GA 31092
Phone (404) 844-9975
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 046-R-0644 | GA | Yes |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
1303 E Union St Ste a
Vienna, GA 31092-7540
Mailing address
1150 Industrial Dr
Suite 142
Vienna, GA 31092-1333
Phone (404) 552-4361
Other providers in Vienna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2023. 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.