Organization
LAUREL BAYE HEALTHCARE OF MACON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM TILLER (CFO)
(843) 216-6800
Entity
Organization
Contact information
Practice address
505 COLISEUM DR, MACON, GA 31217-3840
(478) 743-8687
Mailing address
505 COLISEUM DR, MACON, GA 31217-3840
(478) 743-8687
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1-011-1641
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000141523A
—
GA
Enumeration date
10/07/2005
Last updated
06/20/2011
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