Amicus Home Care
Organization Active NPI Home Health Agency · Tucker, GA
NPI 1447569173 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1447569173
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- AMICUS HOME CARE
- Practice address
- 3469 Lawrenceville Hwy Ste 304
Tucker, GA 30084-5890 - Phone
- (770) 939-0146
- Fax
- (770) 939-0145
- NPI assigned
- Sep 29, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. Osaretin Isibor
- Title
- Ceo
- Phone
- (770) 939-0146
National Provider Directory
Locations
954 S Main St NE
Ste 200
Conyers, GA 30012
3469 Lawrenceville Hwy
Ste 304
Tucker, GA 30084
Phone (770) 939-0146
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes | ||
| Nursing Care Agency | 251J00000X | 122-R-0514 | GA | |
| In Home Supportive Care Agency | 253Z00000X | 122-R-0514 | GA |
Addresses
Primary practice location
3469 Lawrenceville Hwy Ste 304
Tucker, GA 30084-5890
Mailing address
3469 Lawrenceville Hwy Ste 304
Tucker, GA 30084-5890
Phone (770) 939-0146
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003201115A | Medicaid | GA | |
| 003201116A | Medicaid | GA | |
| 919016846C | Medicaid | GA |
Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. 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.