Organization
PRUITTHEALTH HOSPICE, INC.
Active
Other names
PruittHealth Hospice - Macon
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
6060 LAKESIDE COMMONS DR, MACON, GA 31210-5778
(478) 745-9204
(478) 745-9321
Mailing address
1626 JEURGENS CT, LEGAL DEPT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00697716A
—
GA
Enumeration date
06/03/2006
Last updated
09/15/2021
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