MEDICARE: THE FORTNER GROUP 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1770269086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FORTNER GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 250
Second Line	:
City	:	LOWELL
State	:	NC
Zip	:	28098-0250
Country	:	US
Telephone Number	:	423-483-4496
Fax Number	:

Provider Business Practice Location Address
First Line	:	16 OAK GROVE ST
Second Line	:
City	:	MOUNT HOLLY
State	:	NC
Zip	:	28120-1655
Country	:	US
Telephone Number	:	423-483-4496
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MICHAEL SCOTT FORTNER
Credential	:
Telephone Number	:	423-483-4496

Provider Enumeration Date	:	06/22/2023
Last Update Date	:	06/22/2023

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Directions to “THE FORTNER GROUP LLC ” Practice Location

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