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Pruitthealth - Magnolia Manor, Llc

Pruitthealth - Magnolia Manor, Llc is a health care provider in Norcross, GA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 3003 Veterans Parkway South, Moultrie, GA 31788-6705, US
Practice Location Phone229-985-3422
Practice Location Fax229-985-0227
Legal Business NamePRUITTHEALTH - MAGNOLIA MANOR, LLC
Other Organization NamePRUITTHEALTH - MAGNOLIA MANOR
Other Organization Name TypeDoing Business As Name
NPI ?1982651402
Entity TypeOrganization
Enumeration Date ? May 29, 2006
Last Update Date ? Jun 30, 2014
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Pruitthealth - Magnolia Manor, Llc

SpecialtySpecializationLicenseLicense State
Skilled Nursing Facility 1-035-1653Georgia

legacy-id-icon Legacy Provider IDs of Pruitthealth - Magnolia Manor, Llc

Provider IdIssuer StateIssuer TypeIssuer
00252007AGeorgiaMedicaid

official-icon Authorized Official of Pruitthealth - Magnolia Manor, Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Pruitthealth - Magnolia Manor, Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Neil L Pruitt
Authorized Official Title/PositionCHAIRMAN AND CEO
Authorized Official Phone Number770-279-6200