Organization
EXPRESS HOME CARE GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVIAN MCCULLOM (ADMINISTRATOR)
(770) 948-8112
Entity
Organization
Contact information
Practice address
231 MAXHAM RD, SUITE 100, AUSTELL, GA 30168-5523
(770) 948-8112
(770) 948-8113
Mailing address
231 MAXHAM RD, SUITE 100, AUSTELL, GA 30168-5523
(770) 948-8112
(770) 948-8113
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
048R1033
FM
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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