Organization
MEMORIAL CAREONE HOME HEALTH SERVICES INC
Active
Other names
CareOne Home Health Services-Tifton 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
1823 OLD OCILLA RD, TIFTON, GA 31794-1617
(229) 382-0686
(229) 386-5384
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
137111
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00336872A
—
GA
01
—
117423
JCAHO
—
01
—
52158848002
BLUECROSS BLUESHIELD INS
—
Enumeration date
08/04/2006
Last updated
04/20/2008
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