Organization
MERCY'S QUALITY HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MERCY A EKPOUDOM REGISTERED NURSE (ADMINISTRATOR)
(678) 608-7151
Entity
Organization
Contact information
Practice address
120 N BERRY ST, SUITE 101, STOCKBRIDGE, GA 30281-1093
(678) 608-7151
(678) 289-9256
Mailing address
120 N BERRY ST, SUITE 101, STOCKBRIDGE, GA 30281-3411
(678) 608-7151
(678) 289-9256
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003137788A
MEDICAID PROVDER #
GA
01
—
003137789
MEDICAID PROVIDER #
GA
Enumeration date
10/05/2009
Last updated
12/27/2013
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