Organization
EVANS MEMORIAL
Active
Parent organization
EVANS MEMORIAL HOSPITAL
Other names
Glenvue Nursing Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVANS MEMORIAL HOSPITAL
Authorized official
DANNY S LYNN (ADMINISTRATOR)
(912) 654-2138
Entity
Organization
Contact information
Practice address
440 INDUSTRIAL BLVD, HAWKINSVILLE, GA 31036
(478) 783-4988
Mailing address
PO BOX 1033, HAWKINSVILLE, GA 31036-7033
(478) 783-4988
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
06/27/2007
Last updated
01/16/2008
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