MEDICARE: BROWNS TENDER-HEARTED CARE

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	311Z00000X	Custodial Care Facility

General Provider Information

NPI Number	:	1417511841
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWNS TENDER-HEARTED CARE

Provider Business Mailing Address
First Line	:	136 ATTAPULGUS CLIMAX RD
Second Line	:
City	:	CLIMAX
State	:	GA
Zip	:	39834-2707
Country	:	US
Telephone Number	:	229-726-4137
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 VIRGINIA LN
Second Line	:
City	:	CLIMAX
State	:	GA
Zip	:	39834-2872
Country	:	US
Telephone Number	:	229-726-4137
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMERIA MCNAIR
Credential	:	RN BSN
Telephone Number	:	229-726-4137

Provider Enumeration Date	:	05/01/2019
Last Update Date	:	05/01/2019

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