Organization
PIONEER HEALTH SERVICES OF EARLY COUNTY, LLC
Active
Other names
Early Memorial Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH S MCNULTY III (CEO)
(601) 849-6440
Entity
Organization
Contact information
Practice address
11740 COLUMBIA ST, BLAKELY, GA 39823-2574
(229) 723-3795
(229) 723-8024
Mailing address
11740 COLUMBIA ST, BLAKELY, GA 39823-2574
(229) 723-3795
(229) 723-8024
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
049-667
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140873A
—
GA
01
—
049-667
LICENSE
GA
Enumeration date
09/15/2010
Last updated
09/23/2015
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