Fort Gaines Operator Llc

NPI 1750553996 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1750553996
Enumeration Date 03/27/2008
Last Updated 01/23/2015
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name WALDEMAR W. WALDEMAR
Position ADMINISTRATOR
Phone (229) 768-2521
Fax (229) 768-2466
Practice Location
101 HARTFORD RD W
FORT GAINES GA, 39851-4331, US
Phone (229) 768-2521
Fax (229) 768-2466
Business Location
PO BOX 160
FORT GAINES GA, 39851-0160, US
Phone (229) 768-2521
Fax (229) 768-2466
Toxanomy
Taxonomy Code 314000000X
License State Georgia
License Number 1-030-1168
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According to our database, Fort Gaines Operator Llc NPI is 1750553996, taxonomy code is 314000000X and license number is 1-030-1168, license state is located at Georgia. Fort Gaines Operator Llc physically located at 101 Hartford Rd W, Fort Gaines GA, 39851-4331. NPI Number 1033115704 has the healthcare provider type.

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1750553996 NPI number is provided on an as is basis without warranty of any kind. 1750553996 is maintained by the National Plan & Provider Enumeration System. The contents of Fort Gaines Operator Llc are for informational purposes only.