Organization
PRUITTHEALTH - ROME, LLC
Active
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
2 THREE MILE RD NE, ROME, GA 30165-9764
(706) 236-6002
(706) 236-6003
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299031876A
—
GA
Enumeration date
12/19/2013
Last updated
04/13/2015
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