Healthcare Provider Details

I. General information

NPI: 1780617985
Provider Name (Legal Business Name): SYLVESTER HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MONK ST
SYLVESTER GA
31791-7246
US

IV. Provider business mailing address

PO BOX 385
ALBANY GA
31702-0385
US

V. Phone/Fax

Practice location:
  • Phone: 229-776-5541
  • Fax: 229-776-9712
Mailing address:
  • Phone: 229-639-0021
  • Fax: 229-639-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1159702
License Number StateGA

VIII. Authorized Official

Name: MR. DAVIS W KING
Title or Position: PRESIDENT
Credential:
Phone: 229-639-0021