Active NPI
First Corinthian Homecare, Inc.
- In Home Supportive Care Agency
- Marietta, GA
National Provider Identifier
1699058883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 033-R-0815
- Legal business name
- FIRST CORINTHIAN HOMECARE, INC.
- Practice address
- 2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847 - Phone
- (770) 627-5029
- Fax
- (770) 485-5361
- NPI assigned
- Sep 23, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ted Ibegbulam
- Title
- Administrator
- Phone
- (770) 627-5029
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | 033-R-0815 | GA | |
| In Home Supportive Care Agency | 253Z00000X | 033-R-0815 | GA | Primary |
Addresses
Primary practice location
2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847
Mailing address
2759 Delk Rd SE
Suite 2550
Marietta, GA 30067-8847
Phone (770) 627-5029
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003123352A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- First Corinthian Homecare Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- In Home Supportive Care Agency
- Montezuma, GA
- NPI 1124458427
Locations
2759 Delk Rd SE
Ste 2550
Marietta, GA 30067
Phone (770) 627-5029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1336089600000",
"number": "1699058883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2759 DELK RD SE",
"address_2": "SUITE 2550",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678847",
"telephone_number": "770-627-5029",
"fax_number": "770-485-5361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2759 DELK RD SE",
"address_2": "SUITE 2550",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300678847",
"telephone_number": "770-627-5029",
"fax_number": "770-485-5361"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIRST CORINTHIAN HOMECARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-23",
"last_updated": "2012-05-04",
"status": "A",
"authorized_official_last_name": "IBEGBULAM",
"authorized_official_first_name": "TED",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "770-627-5029"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "GA",
"license": "033-R-0815",
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "GA",
"license": "033-R-0815",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003123352A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.