MEDICARE: GREENE COUNTY 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	1-066-1920	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	:	1770525529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENE COUNTY HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	PO BOX 312
Second Line	:
City	:	UNION POINT
State	:	GA
Zip	:	30669-0312
Country	:	US
Telephone Number	:	706-486-2167
Fax Number	:	706-486-4022

Provider Business Practice Location Address
First Line	:	1321 WASHINGTON HIGHWAY
Second Line	:
City	:	UNION POINT
State	:	GA
Zip	:	30669-0312
Country	:	US
Telephone Number	:	706-486-2167
Fax Number	:	706-486-4022

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ZUBAYDA SUTTON
Credential	:
Telephone Number	:	706-486-2167

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/19/2024

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Directions to “GREENE COUNTY HEALTH CARE LLC ” Practice Location

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