Healthcare Provider Details

I. General information

NPI: 1235503772
Provider Name (Legal Business Name): FRANKLIN HEALTHCARE OF LYNCHBURG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 12/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 ATHERHOLT RD
LYNCHBURG VA
24501-2148
US

IV. Provider business mailing address

3050 ROYAL BLVD S STE. 190
ALPHARETTA GA
30022-4427
US

V. Phone/Fax

Practice location:
  • Phone: 434-846-3200
  • Fax: 434-846-3436
Mailing address:
  • Phone: 470-282-3268
  • Fax: 470-268-7957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DOUG MITTLEIDER
Title or Position: PRESIDENT OF MANAGING MEMBER
Credential:
Phone: 470-282-3268