Organization
SCG DURANT FOUR SEASONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D KRAMER (PRESIDENT & CEO)
(813) 341-2700
Entity
Organization
Contact information
Practice address
16 NORCROSS ST, SUITE 100, ROSWELL, GA 30075-3810
(770) 255-1810
(770) 255-0059
Mailing address
16 NORCROSS ST, SUITE 100, ROSWELL, GA 30075-3864
(770) 255-1810
(770) 255-0059
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH 0704
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100769540A
—
OK
01
—
1215926928
NPI
—
Enumeration date
10/04/2006
Last updated
08/04/2008
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