MEDICARE: FLOYD HEALTHCARE MANAGEMENT, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332900000X	Non-Pharmacy Dispensing Site

General Provider Information

NPI Number	:	1104380278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOYD HEALTHCARE MANAGEMENT, INC

Provider Business Mailing Address
First Line	:	420 E 2ND AVE STE 103
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30161-3210
Country	:	US
Telephone Number	:	706-509-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4159 MARTHA BERRY HWY NW
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30165-7705
Country	:	US
Telephone Number	:	706-292-3030
Fax Number	:

Authorized Official
Title or Position	:	VP OF CORPORATE AND NETWORK SERVICE
Name	:	MATTHEW GORMAN
Credential	:
Telephone Number	:	706-509-5000

Provider Enumeration Date	:	01/23/2019
Last Update Date	:	08/08/2022

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