Organization
EVANS MEMORIAL
Active
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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