# PRIMARY MEDICAL HOMECARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIMARY MEDICAL HOMECARE 'PMH' LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043828932
- **Legal business name:** PRIMARY MEDICAL HOMECARE 'PMH' LLC
- **Authorized official:** DR. REDA COSTON PSY.D/PH.D (HEALTHCARE ADMINISTRATOR)
- **Authorized official phone:** (404) 800-5550

## Contact information

- **Practice address:** 2480 WINDY HILL RD SE STE 206, MARIETTA, GA 30067-8656
- **Practice address phone:** (404) 800-5550
- **Mailing address:** 2480 WINDY HILL RD SE STE 206, MARIETTA, GA 30067-8656
- **Mailing address phone:** (404) 800-5550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP1600X | Pastoral Counselor | — | NULL | — |
| 101YP1600X | Pastoral Counselor | — | — | — |
| 163WC0400X | Case Management Registered Nurse | — | NULL | — |
| 163WC0400X | Case Management Registered Nurse | — | — | — |
| 177F00000X | Lodging Provider | — | NULL | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251F00000X | Home Infusion Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |
| 374700000X | Technician | — | NULL | — |
| 374700000X | Technician | — | — | — |

## Other

- **Enumeration date:** 07/17/2020
- **Last updated:** 07/17/2020