Provider Demographics
NPI:1710054705
Name:HAMILTON HOME HEALTH
Entity Type:Organization
Organization Name:HAMILTON HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSN
Authorized Official - Phone:706-226-2848
Mailing Address - Street 1:1200 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-1168
Mailing Address - Country:US
Mailing Address - Phone:706-272-6000
Mailing Address - Fax:706-278-4973
Practice Address - Street 1:1012 BURLEYSON RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:706-226-2848
Practice Address - Fax:706-278-4973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1550123336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00199812AMedicaid
117062Medicare ID - Type Unspecified