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Contact Information

EXTRAORDINARY PRIVATE HOMECARE SERVICES LLC.
302 B-1 RAMSEY ST.
DUBLIN, GA31021
 Phone: 478-274-8787
 Fax: 877-271-3257
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Respite Care

385H00000X
Indicates primary specialty

NPI Profile & details for EXTRAORDINARY PRIVATE HOMECARE SERVICES LLC.

NPI # 1891063947
LBN Legal business name EXTRAORDINARY PRIVATE HOMECARE SERVICES LLC.
Authorized official THERESA ISAAC - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/05/2011
Last updated 03/05/2012 - About 14 years ago
Identifiers
GA License # 087-R-0792
GA License # 087R0792
GA Medicaid 1891063947
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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