Healthcare Provider Details

I. General information

NPI: 1134258965
Provider Name (Legal Business Name): TOOMBS NURSING HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 OXLEY DR
LYONS GA
30436-5644
US

IV. Provider business mailing address

PO BOX 352
LYONS GA
30436-0352
US

V. Phone/Fax

Practice location:
  • Phone: 912-526-6336
  • Fax: 912-526-3290
Mailing address:
  • Phone: 912-526-6336
  • Fax: 912-526-3290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
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