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NPI Code Detail

MEDICARE: PROFESSIONAL RESOURCE MGMT OF RABUN, LLC

MEDICARE: PROFESSIONAL RESOURCE MGMT OF RABUN, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282N00000XGeneral Acute Care Hospital62897GA

General Provider Information

NPI Number : 1427057363
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROFESSIONAL RESOURCE MGMT OF RABUN, LLC
Provider Business Mailing Address
First Line : 196 RIDGECREST CIR
Second Line : SURGICAL SERVICE
City : CLAYTON
State : GA
Zip : 30525-4111
Country : US
Telephone Number : 706-782-4233
Fax Number : 706-782-0451
Provider Business Practice Location Address
First Line : 196 RIDGECREST CIR
Second Line : SURGICAL SERVICE
City : CLAYTON
State : GA
Zip : 30525-4111
Country : US
Telephone Number : 706-782-4233
Fax Number : 706-782-0451
Authorized Official
Title or Position : CEO
Name : MS. KRISTY HALL
Credential :
Telephone Number : 706-782-0400
Provider Enumeration Date : 07/20/2005
Last Update Date : 08/08/2023

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