MEDICARE: WOODLAND HEALTH CARE LLC

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	314000000X	Skilled Nursing Facility	10891823	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255302733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLAND HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 270
Second Line	:
City	:	MIDWAY
State	:	GA
Zip	:	31320
Country	:	US
Telephone Number	:	912-884-3361
Fax Number	:	912-884-5730

Provider Business Practice Location Address
First Line	:	652 N COASTAL HWY 17
Second Line	:
City	:	MIDWAY
State	:	GA
Zip	:	31320
Country	:	US
Telephone Number	:	912-884-3361
Fax Number	:	912-884-5730

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LOUISA WINGET
Credential	:
Telephone Number	:	478-405-0454

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	08/22/2020

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Directions to “WOODLAND HEALTH CARE LLC ” Practice Location

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