Provider Demographics
NPI:1760488548
Name:NOAH'S ARK HOMECARE, INC.
Entity Type:Organization
Organization Name:NOAH'S ARK HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:706-367-2280
Mailing Address - Street 1:1530 RAMBLER INN RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-5625
Mailing Address - Country:US
Mailing Address - Phone:706-367-2280
Mailing Address - Fax:775-242-1463
Practice Address - Street 1:1530 RAMBLER INN RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-5625
Practice Address - Country:US
Practice Address - Phone:706-367-2280
Practice Address - Fax:775-242-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1269750001Medicare NSC