Provider Demographics
NPI:1932435708
Name:TYLO HEALTHCARE, LLC
Entity type:Organization
Organization Name:TYLO HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:TOLNAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-459-0021
Mailing Address - Street 1:4080 MCGINNIS FERRY RD
Mailing Address - Street 2:SUITE 1302
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3948
Mailing Address - Country:US
Mailing Address - Phone:404-459-0021
Mailing Address - Fax:404-459-0031
Practice Address - Street 1:4080 MCGINNIS FERRY RD
Practice Address - Street 2:SUITE 1302
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3948
Practice Address - Country:US
Practice Address - Phone:404-459-0021
Practice Address - Fax:404-459-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X
GA060-R-0451253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA060-R-0451OtherSTATE LICENSE