Provider Demographics
NPI:1316809825
Name:EXCLUSIVE HOMECARE AGENCY LLC
Entity type:Organization
Organization Name:EXCLUSIVE HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANGER
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARTEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-831-4054
Mailing Address - Street 1:2796 SORI DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6618
Mailing Address - Country:US
Mailing Address - Phone:770-831-4054
Mailing Address - Fax:
Practice Address - Street 1:2796 SORI DR
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-6618
Practice Address - Country:US
Practice Address - Phone:770-831-4054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)