# PP&P HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HYDR8ME IV LOUNGE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104626787
- **Legal business name:** HYDR8ME IV LOUNGE
- **Authorized official:** PETRINO PIERCE RN (OWNER)
- **Authorized official phone:** (678) 832-8065

## Contact information

- **Practice address:** 211 PAYTON PL, WOODSTOCK, GA 30188-3185
- **Practice address phone:** (678) 835-8065
- **Practice address fax:** (877) 599-6195
- **Mailing address:** 211 PAYTON PL, WOODSTOCK, GA 30188-3185
- **Mailing address phone:** (678) 835-8065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC1500X | Community Health Registered Nurse | — | NULL | — |
| 163WC1500X | Community Health Registered Nurse | — | — | — |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251F00000X | Home Infusion Agency | — | NULL | — |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 302R00000X | Health Maintenance Organization | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 03/14/2025
- **Last updated:** 03/26/2025