Organization
PRUITTHEALTH - ASHBURN LLC
Active
Other names
PruittHealth - Ashburn
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL L PRUITT JR. (CHAIRMAN AND CEO)
(770) 279-6200
Entity
Organization
Contact information
Practice address
441 INDUSTRIAL DR, BOX 629, ASHBURN, GA 31714-5410
(229) 567-3473
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-142-1163
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00140104A
—
GA
Enumeration date
05/26/2006
Last updated
03/16/2021
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