Provider Demographics
NPI:1083744718
Name:BECKYMART CARE LLC.
Entity Type:Organization
Organization Name:BECKYMART CARE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TAKOW
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:EYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-739-4221
Mailing Address - Street 1:5880 NEWNAN CT
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-7402
Mailing Address - Country:US
Mailing Address - Phone:770-739-4221
Mailing Address - Fax:678-699-7179
Practice Address - Street 1:5880 NEWNAN CT
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-7402
Practice Address - Country:US
Practice Address - Phone:770-739-4221
Practice Address - Fax:678-699-7179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-0097163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty