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Organization
PRIMARY MEDICAL HOMECARE LLC
Active
Organization
PRIMARY MEDICAL HOMECARE LLC
Active
Other names
HomeCare Dispatch PMH LLC Agency
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R. COSTON PSY.D/PH.D (CEO)
(855) 525-1000
Entity
Organization
Contact information
Practice address
2480 WINDY HILL RD SE, SUITE 206, MARIETTA, GA 30067-8644
(855) 525-1000
(855) 525-1056
Mailing address
2480 WINDY HILL RD SE, SUITE 206, MARIETTA, GA 30067-8644
(855) 525-1000
(855) 525-1056
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
033-R-1687
GA
253Z00000X
In Home Supportive Care Agency
Primary
CN0028882028
GA
305S00000X
Point of Service
68372
GA
332BN1400X
Nursing Facility Supplies (DME)
CN0028882028
GA
343800000X
Secured Medical Transport (VAN)
—
GA
Other
Enumeration date
06/23/2015
Last updated
07/21/2022
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