Provider Demographics
NPI:1982844551
Name:ACCUMED HOME HEALTH SERVICES OF GEORGIA, INC
Entity Type:Organization
Organization Name:ACCUMED HOME HEALTH SERVICES OF GEORGIA, INC
Other - Org Name:COMMUNITY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:2801 N DECATUR RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5949
Practice Address - Country:US
Practice Address - Phone:404-294-4114
Practice Address - Fax:404-294-4788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCUMED HOME HEALTH SERVICES OF GEORGIA, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033263H251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA117130Medicare Oscar/Certification