NPIMap

Organization Active NPI

Primary Medical Homecare LLC

Doing business as HomeCare Dispatch PMH LLC Agency

  • In Home Supportive Care Agency
  • Marietta, GA
National Provider Identifier
1750763132
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
CN0028882028 Issued in GA
Legal business name
PRIMARY MEDICAL HOMECARE LLC
Doing business as
HomeCare Dispatch PMH LLC Agency
Practice address
2480 Windy Hill Rd SE
Suite 206
Marietta, GA 30067-8644
Phone
(855) 525-1000
Fax
(855) 525-1056
NPI assigned
Jun 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. R. Coston, PSY.D/PH.D
Title
Ceo
Phone
(855) 525-1000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X 033-R-1687 GA
In Home Supportive Care Agency 253Z00000X CN0028882028 GA Primary
Point of Service 305S00000X 68372 GA
Nursing Facility Supplies (DME) 332BN1400X CN0028882028 GA
Secured Medical Transport (VAN) 343800000X GA

Addresses

Primary practice location

2480 Windy Hill Rd SE
Suite 206
Marietta, GA 30067-8644

Mailing address

2480 Windy Hill Rd SE
Suite 206
Marietta, GA 30067-8644
Phone (855) 525-1000

Other names 1

  • HomeCare Dispatch PMH LLC Agency Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1750763132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 WINDY HILL RD SE",
            "address_2": "SUITE 206",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678644",
            "telephone_number": "855-525-1000",
            "fax_number": "855-525-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 WINDY HILL RD SE",
            "address_2": "SUITE 206",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678644",
            "telephone_number": "855-525-1000",
            "fax_number": "855-525-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COSTON",
        "authorized_official_first_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-525-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D/PH.D"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "GA",
            "license": "033-R-1687",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "CN0028882028",
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "68372",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "GA",
            "license": "CN0028882028",
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeCare Dispatch PMH LLC Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.