Organization
PRUITTHEALTH - VIRGINIA PARK, LLC
Active
Other names
PruittHealth - Virginia Park
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL L. PRUITT JR. (CHAIRMAN AND CEO OF MANAGER)
(770) 279-6200
Entity
Organization
Contact information
Practice address
1000 BRIARCLIFF RD NE, ATLANTA, GA 30306-2618
(404) 875-6456
(404) 874-4606
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
(770) 931-5278
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000140401A
—
GA
Enumeration date
06/10/2015
Last updated
06/10/2015
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