Organization
LOWNDES COUNTY HEALTH SERVICES LLC
Active
Other names
PruittHealth - Crestwood
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
415 PENDLETON PL, VALDOSTA, GA 31602-2632
(229) 242-6868
(229) 242-5357
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
1-092-936
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140764A
—
GA
Enumeration date
06/05/2006
Last updated
05/09/2014
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