Countryside Nursing Llc

NPI 1114365657 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1114365657
Enumeration Date 06/06/2013
Last Updated 09/27/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name TERRY TERRY
Position MANAGER
Phone (770) 646-3861
Fax (770) 646-3601
Practice Location
233 CARROLLTON ST
BUCHANAN GA, 30113-4917, US
Phone (770) 646-3861
Fax (770) 646-3601
Business Location
233 CARROLLTON ST
BUCHANAN GA, 30113-4917, US
Phone (770) 646-3861
Fax (770) 646-3601
Toxanomy
Taxonomy Code 314000000X
License State Georgia
License Number 1-071-2017
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According to our database, Countryside Nursing Llc NPI is 1114365657, taxonomy code is 314000000X and license number is 1-071-2017, license state is located at Georgia. Countryside Nursing Llc physically located at 233 Carrollton St, Buchanan GA, 30113-4917. NPI Number 1033115704 has the healthcare provider type.

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1114365657 NPI number is provided on an as is basis without warranty of any kind. 1114365657 is maintained by the National Plan & Provider Enumeration System. The contents of Countryside Nursing Llc are for informational purposes only.