Organization
PRUITTHEALTH - AUGUSTA, LLC
Active
Other names
PruittHealth - Augusta
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
2541 MILLEDGEVILLE ROAD, AUGUSTA, GA 30904-4954
(706) 738-2581
(706) 738-5235
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
(770) 925-4619
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-121-1724
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059463A
—
GA
Enumeration date
04/03/2008
Last updated
04/23/2014
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