Organization
MEMORIAL CAREONE HOME HEALTH SERVICES, INC
Active
Other names
CareOne Home Health Services-Vidalia Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEANNA M. WILDES RN (DIRECTOR OF OPERATIONS)
(912) 350-6559
Entity
Organization
Contact information
Practice address
201 MAPLE DR, VIDALIA, GA 30474-8906
(912) 537-9004
(912) 537-0235
Mailing address
PO BOX 931861, ATLANTA, GA 31198-1861
(912) 350-6405
(912) 350-6413
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
138-112
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00336894A
—
GA
01
—
117423
JCAHO
—
01
—
51000682 001
BCBS
—
01
—
5817100600 006
BCBS
—
Enumeration date
08/04/2006
Last updated
10/31/2007
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