Provider Demographics
NPI:1285313536
Name:COTTON, MALAYSIA (HOME CARE ADMINISTRA)
Entity type:Individual
Prefix:
First Name:MALAYSIA
Middle Name:
Last Name:COTTON
Suffix:
Gender:F
Credentials:HOME CARE ADMINISTRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30156-0002
Mailing Address - Country:US
Mailing Address - Phone:313-465-5438
Mailing Address - Fax:
Practice Address - Street 1:45 SOUTH AVE SE STE 8
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2538
Practice Address - Country:US
Practice Address - Phone:470-757-2885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2024-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide