Organization Name: | TATTNALL HEALTHCARE LLC. |
NPI Number: | 1619182102 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH A LEWIS (C.F.O.) |
Mailing Address: | 121 N Caswell St Glennville |
State: | GA US |
Postal Code: | 304272017 |
Phone Number: | 9126541080 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 12/06/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |