Organization
WESTBURY MCDONOUGH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENELOPE W GRIFFIN (CHIEF OPERATING OFFICER)
(770) 228-1228
Entity
Organization
Contact information
Practice address
198 HAMPTON ST, MCDONOUGH, GA 30253-3152
(770) 957-9081
(770) 957-3440
Mailing address
198 HAMPTON ST, MCDONOUGH, GA 30253-3152
(770) 957-9081
(770) 957-3440
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10751889
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000143525A
—
GA
01
—
51001223 001
BCBS
—
Enumeration date
06/21/2006
Last updated
08/18/2017
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