MEDICARE: PRUITTHEALTH HOME HEALTH SOUTH GEORGIA, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326989369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRUITTHEALTH HOME HEALTH SOUTH GEORGIA, INC

Provider Business Mailing Address
First Line	:	1626 JEURGENS CT
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30093-2219
Country	:	US
Telephone Number	:	770-279-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 N JEFFERSON ST
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31701-2354
Country	:	US
Telephone Number	:	770-279-6200
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN AND CEO
Name	:	NEIL L PRUITT JR.
Credential	:
Telephone Number	:	770-279-6200

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	05/11/2026

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