Organization
FAMILY HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE ELIZABETH BASS (OWNER)
(678) 519-5593
Entity
Organization
Contact information
Practice address
1572 HIGHWAY 85 N STE 338, FAYETTEVILLE, GA 30214-7729
(678) 519-5593
(678) 519-5674
Mailing address
1572 HIGHWAY 85 N STE 338, FAYETTEVILLE, GA 30214-7729
(678) 519-5593
(678) 519-5674
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003129033A
—
GA
Enumeration date
07/06/2009
Last updated
01/07/2013
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