Healthcare Provider Details

I. General information

NPI: 1619200060
Provider Name (Legal Business Name): MERIWETHER HEALTHCARE, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 SPRING ST
WARM SPRINGS GA
31830-2149
US

IV. Provider business mailing address

5995 SPRING ST
WARM SPRINGS GA
31830-2149
US

V. Phone/Fax

Practice location:
  • Phone: 706-655-3331
  • Fax: 706-655-9266
Mailing address:
  • Phone: 706-655-3331
  • Fax: 706-655-9266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1-099-1813
License Number StateGA

VIII. Authorized Official

Name: MRS. KAREN DANIEL
Title or Position: CEO
Credential:
Phone: 706-655-3331