PRIMARY MEDICAL HOMECARE LLC (NPI# 1750763132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750763132 |
| Entity Type | Organization |
| Organization Name | PRIMARY MEDICAL HOMECARE LLC |
| Other Organization Name | HOMECARE DISPATCH PMH LLC AGENCY |
| Practice Address |
2480 Windy Hill Rd Se Suite 206 Marietta GA 30067-8644 |
| Practice Telephone | 8555251000 |
| Practice Fax Number | 8555251056 |
| Mailing Telephone | 8555251000 |
| Mailing Fax Number | 8555251056 |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | DR. R. COSTON (CEO) |
| Authorized Official Telephone | 8555251000 |
| Authorized Official Credential | PSY.D/PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305S00000X | Point of Service | 68372 | GA | Managed Care Organizations |
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
CN0028882028 | GA | Suppliers |
| N | 343800000X | Secured Medical Transport (VAN) | ========= | GA | Transportation Services |
| N | 251F00000X | Home Infusion | 033-R-1687 | GA | Agencies |
| Y | 253Z00000X | In Home Supportive Care | CN0028882028 | GA | Agencies |
| Other Name | Type Code |
|---|---|
| HomeCare Dispatch PMH LLC Agency | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828932 | Primary Medical Homecare LLC | Counselor | 2480 Windy Hill Rd Se Ste 206, Marietta, GA 30067-8656 | 2020-07-17 |
| Street Address |
2480 WINDY HILL RD SE SUITE 206 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30067-8644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386647139 | Peter S Trager | Dentist | 2480 Windy Hill Rd Se, Ste 405, Marietta, GA 30067-8658 | 2005-05-24 |
| 1942723655 | Naa Jamah Crump | Chiropractor | 2480 Windy Hill Rd Se, Ste 405, Marietta, GA 30067-8658 | 2017-07-25 |
| 1245620558 | Dr. Jay K. Kansal, Dmd, PC | Dentist | 2480 Windy Hill Rd Se, Suite 405, Marietta, GA 30067-8644 | 2015-01-26 |
| 1750690848 | Bryan Jefferies, M.d., P.C. | Ophthalmology | 2480 Windy Hill Rd Se, Suite 400, Marietta, GA 30067-8644 | 2010-10-07 |
| 1124353339 | Pro- Holism Professional Corporation | Psychologist | 2480 Windy Hill Rd Se, Suite 206, Marietta, GA 30067-8644 | 2009-10-06 |
| 1235464561 | Reda Coston | Psychologist | 2480 Windy Hill Rd Se, Suite 206, Marietta, GA 30067-8644 | 2009-10-05 |
| 1912190976 | Bill Lee Wallace | Family Medicine | 2480 Windy Hill Rd Se, Suite 200, Marietta, GA 30067-8644 | 2007-08-23 |
| 1437365616 | Paul Aaron Goldberg | Chiropractor | 2480 Windy Hill Rd Se, Suite 203, Marietta, GA 30067-8644 | 2007-05-15 |
| 1720160922 | Bryan G Jefferies | Ophthalmology | 2480 Windy Hill Rd Se, Suite 400, Marietta, GA 30067-8644 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140022 | Sherry Wilson King | Marriage & Family Therapist | 1640 Powers Ferry Rd Blg 7, Ste 300, Marietta, GA 30067 | 2018-10-23 |
| 1053886861 | Precious Angel Home Care Services Inc | Adult Companion | 2470 Windy Hill Road, Marietta, Suite 253, Marietta, GA 30067 | 2018-10-08 |
| 1194206466 | Joshua P Moree | Chiropractor | 860 Franklin Gtwy Se Apt 111, Marietta, GA 30067 | 2018-08-24 |
| 1841778081 | Sun Pediatrics LLC | Pediatrics | 2520 Windy Hill Rd Se Ste 104, Marietta, GA 30067 | 2018-07-31 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1497254213 | Allison M Jancik | Chiropractor | 1355 Terrell Mill Road Se, Bldg 1474, Ste 150, Marietta, GA 30067 | 2018-02-07 |
| 1801304969 | Danielle Ann Dietrich | Chiropractor | 805 Winterset Pkwy Se, Marietta, GA 30067 | 2018-01-11 |
| 1740794866 | Jessica Lofgren | Chiropractor | 1130 Northchase Pkwy Se Ste 125, Marietta, GA 30067 | 2017-11-28 |
| 1871026393 | Rhonda Dawes Milner | Counselor | 1640 Powers Ferry Rd Bldg 16, Suite 100, Marietta, GA 30067 | 2017-04-11 |
| 1457894537 | Carcelia Delk | Counselor | 1110 Augusta Dr Se, Marietta, GA 30067 | 2016-11-22 |
| Find all providers in zip 30067 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902415391 | Pure Guardian Care LLC | In Home Supportive Care | 2599 Candler Way Sw, Marietta, GA 30064-4270 | 2020-07-30 |
| 1982221693 | North Fulton Medical Consultants | In Home Supportive Care | 3162 Johnson Ferry Rd Ste 260-425, Marietta, GA 30062-7604 | 2020-06-29 |
| 1619598257 | Truvita Corp. | In Home Supportive Care | 324 Cherokee St Ne, Marietta, GA 30060-1389 | 2020-05-06 |
| 1871112342 | 4 Seasons Home Care, Inc. | In Home Supportive Care | 78 Cole St Ne Ste 100, Marietta, GA 30060-2020 | 2020-04-14 |
| 1982161642 | Sunrise Horizons, LLC | In Home Supportive Care | 3724 Langley Oaks Pl Se, Marietta, GA 30067-4978 | 2019-02-28 |
| 1285119693 | Precious Angel Home Care Services Inc | In Home Supportive Care | 2470 Windy Hill Rd Se Ste 253, Marietta, GA 30067-8619 | 2018-10-02 |
| 1720561020 | Tripmar Enterprises Inc | In Home Supportive Care | 2000 First Dr Ste 320, Marietta, GA 30062-7741 | 2018-09-12 |
| 1386159408 | Better At Home LLC | In Home Supportive Care | 732 Kennesaw Ave Nw Ste 250, Marietta, GA 30060-9406 | 2017-12-12 |
| 1538681994 | Passionate Care | In Home Supportive Care | 1110 Renfro Ln., Marietta, GA 30066 | 2017-07-07 |
| 1619339793 | Jack Redmond Home Care Inc. | In Home Supportive Care | 1000 Whitlock Ave Nw Ste 320, Marietta, GA 30064-5449 | 2016-03-28 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.