Organization
PRUITTHEALTH - FARMVILLE LLC
Active
Other names
PruittHealth - Farmville
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL L PRUITT (CHAIRMAN AND CEO OF MANAGER)
(770) 279-6200
Entity
Organization
Contact information
Practice address
4351 S MAIN ST, FARMVILLE, NC 27828-9532
(252) 753-5547
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0304
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3415384
—
NC
05
—
3426241
—
NC
Enumeration date
05/26/2006
Last updated
06/30/2014
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