Heritage Medical House Call

NPI 1063778983 - Home Health - 251E00000X

NPI Details
NPI 1063778983
Enumeration Date 04/04/2012
Last Updated 10/31/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name KEVIN ALEXANDER KEVIN
Position OWNER/MEMBER
Phone (888) 461-9765
Fax (678) 381-1684
Practice Location
925 MAIN STREET
SUITE 300-13
STONE MOUNTAIN GA, 30083-3098, US
Phone (888) 461-9765
Fax (678) 381-1684
Business Location
925 MAIN ST
SUITE 300-13
STONE MOUNTAIN GA, 30083-3098, US
Phone (888) 461-9765
Fax (678) 381-1684
Toxanomy
Taxonomy Code 251E00000X
License State Georgia
License Number 12018049
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According to our database, Heritage Medical House Call NPI is 1063778983, taxonomy code is 251E00000X and license number is 12018049, license state is located at Georgia. Heritage Medical House Call physically located at 925 Main Street, Stone Mountain GA, 30083-3098. NPI Number 1033115704 has the healthcare provider type.

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1063778983 NPI number is provided on an as is basis without warranty of any kind. 1063778983 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Medical House Call are for informational purposes only.