Provider Demographics
NPI:1720447311
Name:GOLDEN LIFE PATIENT CARE
Entity Type:Organization
Organization Name:GOLDEN LIFE PATIENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-241-7921
Mailing Address - Street 1:35 WRIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-3180
Mailing Address - Country:US
Mailing Address - Phone:770-241-7921
Mailing Address - Fax:
Practice Address - Street 1:35 WRIGHT WAY
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-3180
Practice Address - Country:US
Practice Address - Phone:770-241-7921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHEILA GILBERT ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care