Healthcare Provider Details

I. General information

NPI: 1992743975
Provider Name (Legal Business Name): NATIONAL HEALTHCARE CENTER OF FT OGLETHORPE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2403 BATTLEFIELD PKWY
FT OGLETHORPE GA
30742-4033
US

IV. Provider business mailing address

2403 BATTLEFIELD PKWY
FT OGLETHORPE GA
30742-4033
US

V. Phone/Fax

Practice location:
  • Phone: 706-866-7700
  • Fax:
Mailing address:
  • Phone: 706-866-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10231207
License Number StateGA

VIII. Authorized Official

Name: GREG BIDWELL
Title or Position: REGIONAL VICE PRESIDENT
Credential:
Phone: 865-523-2473