Organization
PRUITTHEALTH - DECATUR, LLC
Active
Other names
PruittHealth - Decatur
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL L. PRUITT JR. (CHAIRMAN AND CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
3200 PANTHERSVILLE ROAD, DECATUR, GA 30034-3831
(404) 212-3400
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00252942A
—
GA
Enumeration date
12/08/2009
Last updated
06/30/2014
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