Provider Demographics
NPI:1669272704
Name:JDH HOME HEALTHCARE
Entity type:Organization
Organization Name:JDH HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHARMACY TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBRIELLE
Authorized Official - Middle Name:RASHONDA JANIQUE
Authorized Official - Last Name:HAGANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY TECHNICIAN
Authorized Official - Phone:478-232-0187
Mailing Address - Street 1:434 MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:TENNILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31089-4120
Mailing Address - Country:US
Mailing Address - Phone:478-232-0187
Mailing Address - Fax:478-232-0187
Practice Address - Street 1:434 MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:TENNILLE
Practice Address - State:GA
Practice Address - Zip Code:31089-4120
Practice Address - Country:US
Practice Address - Phone:478-232-0187
Practice Address - Fax:478-232-0187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care