Organization
FT GAINES HEALTHCARE LLC
Active
Other names
Ft. Gaines Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
TYGH BROGDON (MANAGER)
(770) 650-8773
Entity
Organization
Contact information
Practice address
101 HARTFORD RD, FORT GAINES, GA 39851-3639
(229) 768-2521
(229) 768-2466
Mailing address
101 HARTFORD RD, FORT GAINES, GA 39851-3639
(229) 768-2521
(229) 768-2466
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140599A
—
GA
Enumeration date
05/31/2005
Last updated
09/29/2008
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