Organization
PRIMARY MEDICAL HOMECARE LLC
Active
Parent organization
PRIMARY MEDICAL HOMECARE 'PMH' LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMARY MEDICAL HOMECARE 'PMH' LLC
Authorized official
DR. REDA COSTON PSY.D/PH.D (HEALTHCARE ADMINISTRATOR)
(404) 800-5550
Entity
Organization
Contact information
Practice address
2480 WINDY HILL RD SE STE 206, MARIETTA, GA 30067-8656
(404) 800-5550
Mailing address
2480 WINDY HILL RD SE STE 206, MARIETTA, GA 30067-8656
(404) 800-5550
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
163WC0400X
Case Management Registered Nurse
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
291U00000X
Clinical Medical Laboratory
—
—
347C00000X
Private Vehicle
—
—
374700000X
Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033-R-1687
DEPT. OF COMMUNITY HEALTH
GA
Enumeration date
07/17/2020
Last updated
07/17/2020
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