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General NPI Number Information
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NPI Number | 1992738199
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Entity Type | Organization
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Legal Business Name | TIFT HEALTH CARE, INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2002 TIFT AVE N
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City | TIFTON
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State | GA
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Zip | 31794-1824
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Country | US
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Telephone | 229-382-7342
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Fax | 229-382-5577
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Provider Business Mailing Address
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Address Line | PO BOX 1668
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City | TIFTON
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State | GA
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Zip | 31793-1668
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Country | US
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Telephone | 229-382-7342
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Fax | 229-382-5577
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVIS W KING
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Credential |
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Telephone | 229-639-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1137704
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License Number State | GA
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