# HERITAGE MEDICAL HOUSE CALL

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063778983
- **Authorized official:** MR. KEVIN ALEXANDER LANE SR. PA (OWNER/MEMBER)
- **Authorized official phone:** (888) 461-9765

## Contact information

- **Practice address:** 925 MAIN STREET, SUITE 300-13, STONE MOUNTAIN, GA 30083-3098
- **Practice address phone:** (888) 461-9765
- **Practice address fax:** (678) 381-1684
- **Mailing address:** 925 MAIN ST, SUITE 300-13, STONE MOUNTAIN, GA 30083-3098
- **Mailing address phone:** (888) 461-9765
- **Mailing address fax:** (678) 381-1684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 12018049 | GA | Yes |

## Other

- **Enumeration date:** 04/04/2012
- **Last updated:** 10/31/2012