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Organization

PROFESSIONAL MEDICAL HOME HEALTHCARE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM PERNELL (ADMINISTRATOR)
(404) 292-9190
Entity
Organization

Contact information

Practice address
4859C MEMORIAL DR, STONE MOUNTAIN, GA 30083-4175
(404) 292-9190
(404) 508-9225
Mailing address
4859C MEMORIAL DR, STONE MOUNTAIN, GA 30083-4175
(404) 292-9190
(404) 508-9225

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00612818A
GA
05
00814888A
GA
05
00814888B
GA
Enumeration date
12/28/2005
Last updated
11/02/2007
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