Organization
ALTAMAHA NURSING LLC
Active
Other names
Altamaha Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
TYGH BROGDON (MANAGER)
(770) 650-8773
Entity
Organization
Contact information
Practice address
1311 W CHERRY ST, JESUP, GA 31545-0614
(912) 427-7792
(912) 530-9425
Mailing address
1311 W CHERRY ST, JESUP, GA 31545-0614
(912) 427-7792
(912) 530-9425
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-151-1733
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000140027A
—
GA
Enumeration date
06/17/2006
Last updated
09/29/2008
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