Organization
PRUITTHEALTH - WEST ATLANTA, LLC
Active
Other names
PruittHealth - West Atlanta
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
2645 WHITING ST NW, ATLANTA, GA 30318-4563
(404) 799-9267
Mailing address
1626 JEURGENS CT, NORCROSS, GA 30093-2219
(770) 279-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-060-1647
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00256088A
—
GA
Enumeration date
05/29/2006
Last updated
07/02/2014
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