MEDICARE: DURALL CAPITAL HOLDINGS, 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	282NR1301X	Rural Acute Care Hospital

General Provider Information

NPI Number	:	1700883246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURALL CAPITAL HOLDINGS, LLC

Provider Business Mailing Address
First Line	:	227 MOUNTAIN DRIVE
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533
Country	:	US
Telephone Number	:	706-864-6136
Fax Number	:	706-864-1356

Provider Business Practice Location Address
First Line	:	227 MOUNTAIN DRIVE
Second Line	:
City	:	DAHLONEGA
State	:	GA
Zip	:	30533
Country	:	US
Telephone Number	:	706-864-6136
Fax Number	:	706-864-1356

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MS. NATASHEA M BENNETT
Credential	:	LPN
Telephone Number	:	706-265-8439

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/21/2022

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