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NPI 1164876272

NPI 1164876272 : FLOYD HEALTHCARE MANAGEMENT, INC : ROCKMART, GA

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General NPI Number Information
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    NPI Number           |    1164876272
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    Entity Type          |    Organization 
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    Legal Business Name  |    FLOYD HEALTHCARE MANAGEMENT, INC 
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Dates
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    Enumeration Date     |    04/15/2016
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    Last Update Date     |    08/08/2022
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Provider Practice Location Address
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    Address Line         |    1650 CHATTAHOOCHEE DR 
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    City                 |    ROCKMART
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    State                |    GA
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    Zip                  |    30153-2023
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    Country              |    US
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    Telephone            |    770-684-6100
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    Fax                  |    770-684-7522
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Provider Business Mailing Address
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    Address Line         |    420 E 2ND AVE SUITE 103
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    City                 |    ROME
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    State                |    GA
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    Zip                  |    30161
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    Country              |    US
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    Telephone            |    706-509-3000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP OF CORPORATE AND NETWORK SERVICE
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    Name                 |     MATTHEW  GORMAN 
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    Credential           |    
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    Telephone            |    706-509-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332900000X
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    Taxonomy Name        |    Non-Pharmacy Dispensing Site
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    License Number       |    057556
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    License Number State |    GA
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