Pacific Health Systems LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

075-R-1482 Issued in GA

Legal business name

PACIFIC HEALTH SYSTEMS LLC

Practice address

110 Eagle Spring Dr
Suite C
Stockbridge, GA 30281-6488

Phone

(678) 480-5315

Fax

(404) 745-0340

NPI assigned

Aug 3, 2016

Organization subpart

No

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

Authorized official

Name

Remigius I IdaeworNPI 1801349204

Title

Owner

Phone

(678) 480-5315

Specialties & licenses 1

Addresses

Other names 1

• Pacific Home Health Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Remigius Idaewor

  • Community Health Registered Nurse
  • Stockbridge, GA
  • NPI 1801349204
  NPD (past) Authorized official

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1568915809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EAGLE SPRING DR",
            "address_2": "SUITE C",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816488",
            "telephone_number": "678-480-5315",
            "fax_number": "404-745-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EAGLE SPRING DR",
            "address_2": "SUITE C",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816488",
            "telephone_number": "678-480-5315",
            "fax_number": "404-745-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEALTH SYSTEMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "IDAEWOR",
        "authorized_official_first_name": "REMIGIUS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-480-5315"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "075-R-1482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antonette Michell Owens-Peete
• April Tamika Owens
• Carla Owens
• John Larry Ozoh, DPT
• Thomas Allen Pace, PT, DPT
• Devika Padilla
• Sarai Padilla, PSY.D.
• Pain Care Center of Georgia LLC
• Pain Care LLC
• Pain Center at Piedmont LLC. ASC

• Home Health Agency in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.