Organization
LAGRANGE TROUP COUNTY HOSPITAL AUTHORITY
Active
Other names
West Georgia Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD N FULKS (PRESIDENT CEO)
(706) 845-3244
Entity
Organization
Contact information
Practice address
120 GLENN BASS RD, LAGRANGE, GA 30240-5809
(706) 845-3291
(706) 845-3902
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 845-3291
(706) 845-3902
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00145681A
—
GA
Enumeration date
02/15/2006
Last updated
11/05/2007
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