Provider Demographics
NPI:1457673279
Name:MEDICAL & HOMECARE ASSOCIATES OF GEORGIA INC
Entity Type:Organization
Organization Name:MEDICAL & HOMECARE ASSOCIATES OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ECHEBELEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-844-9975
Mailing Address - Street 1:4100 RIVERSIDE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1848
Mailing Address - Country:US
Mailing Address - Phone:404-552-4361
Mailing Address - Fax:229-888-3558
Practice Address - Street 1:37 S SECOND AVE STE A
Practice Address - Street 2:
Practice Address - City:MC RAE
Practice Address - State:GA
Practice Address - Zip Code:31055-4658
Practice Address - Country:US
Practice Address - Phone:404-844-9975
Practice Address - Fax:888-687-4829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-21
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-0706251E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies