Provider Demographics
NPI:1700490174
Name:MOYE HOMECARE
Entity type:Organization
Organization Name:MOYE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:OYEBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OYEWUMI
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:404-934-5384
Mailing Address - Street 1:479 SHADY GLN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-0516
Mailing Address - Country:US
Mailing Address - Phone:404-934-5384
Mailing Address - Fax:
Practice Address - Street 1:479 SHADY GLN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-0516
Practice Address - Country:US
Practice Address - Phone:404-934-5384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-03
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0000Medicaid