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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