Healthcare Provider Details

I. General information

NPI: 1770505794
Provider Name (Legal Business Name): TAYLOR COUNTY HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HIGHWAY 19, SOUTH
BUTLER GA
31006-2400
US

IV. Provider business mailing address

PO BOX 2400
BUTLER GA
31006-2400
US

V. Phone/Fax

Practice location:
  • Phone: 478-862-2220
  • Fax: 478-862-2626
Mailing address:
  • Phone: 478-862-2220
  • Fax: 478-862-2626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number1-133-1701
License Number StateGA

VIII. Authorized Official

Name: KIM SHEFFIELD
Title or Position: VP OF FINANCIAL REPORTING
Credential:
Phone: 478-621-2100