Organization Active NPI

Mountain Home Care Equipment, Inc

  • Prosthetic/Orthotic Supplier
  • Ellijay, GA
National Provider Identifier
1962536219
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MOUNTAIN HOME CARE EQUIPMENT, INC
Practice address
200 Industrial Blvd Ste 113
Ellijay, GA 30540-3721
Phone
(706) 635-4494
Fax
(706) 635-3910
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Pam Rhodes
Title
Co-Owner
Phone
(706) 635-4494

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

200 Industrial Blvd Ste 113
Ellijay, GA 30540-3721

Mailing address

PO Box 675
Ellijay, GA 30540-0009
Phone (706) 635-4494

Other identifiers 2

IdentifierTypeStateIssuer
00319503AMedicaidGA
1669435715OtherGANPI

National Provider Directory

National Provider Directory
Tax ID family
Mountain Home Care Eqpt2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Industrial Blvd
Ste 113
Ellijay, GA 30540
Phone (703) 635-4494

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962536219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 675",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305400009",
            "telephone_number": "706-635-4494",
            "fax_number": "706-635-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 INDUSTRIAL BLVD STE 113",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305403721",
            "telephone_number": "706-635-4494",
            "fax_number": "706-635-3910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HOME CARE EQUIPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RHODES",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "706-635-4494",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00319503A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669435715",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellijay, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.