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General NPI Number Information
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NPI Number | 1790954733
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Entity Type | Organization
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Legal Business Name | GILLIARD HEALTH SERVICES
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 220 HOSPITAL DR
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City | JACKSON
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State | AL
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Zip | 36545-2459
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Country | US
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Telephone | 251-246-9021
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Fax | 251-246-1122
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Provider Business Mailing Address
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Address Line | 220 HOSPITAL DR
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City | JACKSON
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State | AL
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Zip | 36545-2459
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Country | US
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Telephone | 251-246-9021
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Fax | 251-246-1122
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | MRS. JENNIFER RYLAND
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Credential |
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Telephone | 251-246-9021
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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 | 11779
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License Number State | AL
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