Organization
PRUITTHEALTH - BETHANY, LLC
Active
Other names
PruittHealth - Bethany
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL L. PRUITT JR. (CHAIRMAN AND CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
466 SOUTH GRAY STREET, MILLEN, GA 30442-5237
(478) 982-2531
(478) 982-3131
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
—
00140269A
—
GA
Enumeration date
11/02/2010
Last updated
06/27/2014
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