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General NPI Number Information
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NPI Number | 1790620128
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Entity Type | Organization
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Legal Business Name | PRUITTHEALTH HOME HEALTH - SOUTH GEORGIA II INC
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Dates
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Enumeration Date | 04/22/2026
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Last Update Date | 04/22/2026
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Provider Practice Location Address
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Address Line | 1823 OLD OCILLA RD
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City | TIFTON
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State | GA
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Zip | 31794-1617
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Country | US
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Telephone | 770-279-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 JEURGENS CT
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City | NORCROSS
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State | GA
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Zip | 30093-2219
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Country | US
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Telephone | 770-279-6200
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN AND CEO
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Name | NEIL L PRUITT JR.
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Credential |
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Telephone | 770-279-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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