Organization
PRUITTHEALTH - ESTILL, LLC
Active
Other names
PruittHealth - Estill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL LITTLE PRUITT JR. (CHAIRMAN/CEO OF MGR)
(770) 279-6200
Entity
Organization
Contact information
Practice address
252 LIBERTY STREET SOUTH, ESTILL, SC 29918-3311
(803) 625-3852
(803) 625-2441
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF922
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0585NH
—
SC
Enumeration date
11/07/2005
Last updated
06/30/2014
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