MEDICARE: PREFERRED HEALTH HOLDINGS 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
1	314000000X	Skilled Nursing Facility	10607	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629065289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED HEALTH HOLDINGS LLC

Provider Business Mailing Address
First Line	:	3120 NORTH ST
Second Line	:
City	:	GUNTERSVILLE
State	:	AL
Zip	:	35976-2912
Country	:	US
Telephone Number	:	256-582-6561
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 NORTH ST
Second Line	:
City	:	GUNTERSVILLE
State	:	AL
Zip	:	35976-2962
Country	:	US
Telephone Number	:	256-582-6561
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JERRY SOUTH
Credential	:
Telephone Number	:	256-582-6561

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	08/17/2007

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Directions to “PREFERRED HEALTH HOLDINGS LLC ” Practice Location

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