Provider Demographics
NPI:1174834998
Name:DINWIDDIE HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:DINWIDDIE HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGNON
Authorized Official - Middle Name:
Authorized Official - Last Name:DINWIDDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-338-2437
Mailing Address - Street 1:3050 SPRING HILL PKWY SE
Mailing Address - Street 2:H
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6007
Mailing Address - Country:US
Mailing Address - Phone:931-338-2437
Mailing Address - Fax:
Practice Address - Street 1:3050 SPRING HILL PKWY SE
Practice Address - Street 2:H
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6007
Practice Address - Country:US
Practice Address - Phone:931-338-2437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health