Healthcare Provider Details

I. General information

NPI: 1881144665
Provider Name (Legal Business Name): FLOYD HEALTHCARE MANAGEMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11766 HIGHWAY 27
SUMMERVILLE GA
30747-5989
US

IV. Provider business mailing address

420 E 2ND AVE SUITE 103
ROME GA
30161-3209
US

V. Phone/Fax

Practice location:
  • Phone: 706-857-1010
  • Fax:
Mailing address:
  • Phone: 706-509-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number057556
License Number StateGA

VIII. Authorized Official

Name: MATTHEW GORMAN
Title or Position: VP OF CORPORATE AND NETWORK SERVICE
Credential:
Phone: 706-509-5000