Provider Demographics
NPI:1366271116
Name:FRUIT OF THE SPIRIT COMPANION SERVICES
Entity type:Organization
Organization Name:FRUIT OF THE SPIRIT COMPANION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-718-8793
Mailing Address - Street 1:2004 CARVER DR
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31030-4443
Mailing Address - Country:US
Mailing Address - Phone:478-718-8793
Mailing Address - Fax:
Practice Address - Street 1:2004 CARVER DR
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:GA
Practice Address - Zip Code:31030-4443
Practice Address - Country:US
Practice Address - Phone:478-718-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care