Provider Demographics
NPI:1891983425
Name:CENTIVA HOMECARE, INC.
Entity Type:Organization
Organization Name:CENTIVA HOMECARE, INC.
Other - Org Name:CENTIVA MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMOAKUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-688-8535
Mailing Address - Street 1:285 CENTENNIAL OLYMPIC PARK DR NW
Mailing Address - Street 2:UNIT 903
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-1834
Mailing Address - Country:US
Mailing Address - Phone:404-688-8535
Mailing Address - Fax:
Practice Address - Street 1:285 CENTENNIAL OLYMPIC PARK DR NW
Practice Address - Street 2:UNIT 903
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-1834
Practice Address - Country:US
Practice Address - Phone:404-688-8535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies