Provider Demographics
NPI:1417935701
Name:WELLSTAR HOMECARE BILLING, LLC
Entity Type:Organization
Organization Name:WELLSTAR HOMECARE BILLING, LLC
Other - Org Name:WELLSTAR HOMECARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACTING PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-792-7600
Mailing Address - Street 1:805 SANDY PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6340
Mailing Address - Country:US
Mailing Address - Phone:770-792-1616
Mailing Address - Fax:770-792-1785
Practice Address - Street 1:805 SANDY PLAINS RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6340
Practice Address - Country:US
Practice Address - Phone:770-792-1616
Practice Address - Fax:770-792-1785
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLSTAR HEALTH SYSTEM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-06
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008449251F00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00848416BMedicaid
GA3727790001Medicare NSC
GA00848416BMedicaid