Organization
TATTNALL NURSING LLC
Active
Other names
Tattnall Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
TYGH BROGDON (MANAGER)
(770) 650-8773
Entity
Organization
Contact information
Practice address
142 MEMORIAL DR, REIDSVILLE, GA 30453-4652
(912) 557-4345
(912) 557-3019
Mailing address
142 MEMORIAL DR, REIDSVILLE, GA 30453-4652
(912) 557-4345
(912) 557-3019
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-132-1734
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000143228A
—
GA
Enumeration date
06/10/2006
Last updated
09/29/2008
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