Provider Demographics
NPI: | 1073299574 |
---|---|
Name: | HOSPITAL IN YOUR HOME USA INC |
Entity Type: | Organization |
Organization Name: | HOSPITAL IN YOUR HOME USA INC |
Other - Org Name: | HOSPITAL IN YOUR HOME |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | COO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NOVELLA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TASCOE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | JD |
Authorized Official - Phone: | 404-840-0747 |
Mailing Address - Street 1: | 3755 MAIN ST UNIT 101 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLLEGE PARK |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30337-3543 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 844-960-4494 |
Mailing Address - Fax: | 877-716-7831 |
Practice Address - Street 1: | 3755 MAIN ST UNIT 101 |
Practice Address - Street 2: | |
Practice Address - City: | COLLEGE PARK |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30337-3543 |
Practice Address - Country: | US |
Practice Address - Phone: | 844-690-4494 |
Practice Address - Fax: | 877-716-7831 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-06-27 |
Last Update Date: | 2023-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |