Provider Demographics
NPI:1518106343
Name:BUFORD HOME CARE,LLC
Entity Type:Organization
Organization Name:BUFORD HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GOODDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:URHUOGO
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:770-831-8782
Mailing Address - Street 1:4420 S LEE ST STE 108
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3651
Mailing Address - Country:US
Mailing Address - Phone:770-831-8782
Mailing Address - Fax:770-831-8798
Practice Address - Street 1:4420 S LEE ST STE 108
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3651
Practice Address - Country:US
Practice Address - Phone:770-831-8782
Practice Address - Fax:770-831-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-0403251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health