Provider Demographics
NPI:1992966790
Name:AMERICAN HOME CARE & MEDICAL SERVICES
Entity type:Organization
Organization Name:AMERICAN HOME CARE & MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:OHANAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-787-6040
Mailing Address - Street 1:841 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-6756
Mailing Address - Country:US
Mailing Address - Phone:478-787-6040
Mailing Address - Fax:478-787-6039
Practice Address - Street 1:841 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-6756
Practice Address - Country:US
Practice Address - Phone:478-787-6040
Practice Address - Fax:478-787-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011R0376251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA011R0376OtherDEPARTMENT OF HUMAN RESOURCES