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NPI Code Detail

MEDICARE: PRESBYTERIAN HOME, QUITMAN, INC.

MEDICARE: PRESBYTERIAN HOME, QUITMAN, 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
1314000000XSkilled Nursing Facility
2313M00000XNursing Facility/Intermediate Care Facility

Other Identifiers

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

General Provider Information

NPI Number : 1336139070
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESBYTERIAN HOME, QUITMAN, INC.
Provider Business Mailing Address
First Line : PO BOX 407
Second Line :
City : QUITMAN
State : GA
Zip : 31643-3913
Country : US
Telephone Number : 229-263-6100
Fax Number : 229-263-6151
Provider Business Practice Location Address
First Line : 1901 W SCREVEN ST
Second Line :
City : QUITMAN
State : GA
Zip : 31643-3913
Country : US
Telephone Number : 229-263-6100
Fax Number : 229-263-6195
Authorized Official
Title or Position : CFO
Name : DIANNE ARRENDALE
Credential : CPA
Telephone Number : 229-263-6193
Provider Enumeration Date : 10/25/2005
Last Update Date : 08/08/2023

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