MEDICARE: THE PLACE AT POOLER, 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

General Provider Information

NPI Number	:	1902830961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PLACE AT POOLER, LLC

Provider Business Mailing Address
First Line	:	508 S ROGERS ST
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-3116
Country	:	US
Telephone Number	:	912-748-6840
Fax Number	:	912-748-5214

Provider Business Practice Location Address
First Line	:	508 S ROGERS ST
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-3116
Country	:	US
Telephone Number	:	912-748-6840
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	W MELISSA ODEN
Credential	:
Telephone Number	:	615-585-4444

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1710989462 — EAGLES NEST TRUCK STATION INC
Practice Location Address:

508 S ROGERS ST
POOLER, GA
31322-3116

Practice Phone: 912-748-6842
Practice Fax: 912-748-5214

1710978234 — EAGLE'S NEST TRUCK STATION, INC
Practice Location Address:

508 S ROGERS ST
POOLER, GA
31322-3116

Practice Phone: 912-748-6842
Practice Fax: 912-748-5214

1245889294 — RESORTS AT POOLER INC
Practice Location Address:

508 S ROGERS ST
POOLER, GA
31322-3116

Practice Phone: 912-748-6840
Practice Fax:

1922720846 — MRS. SYDNIE LEEANN FORDHAM BCBA
Practice Location Address:

105 GRAND CENTRAL BLVD
POOLER, GA
31322-4148

Practice Phone: 912-244-3305
Practice Fax:

1891545950 — NICOLE ETHRIDGE M.S., CCC-SLP
Practice Location Address:

110 PIPEMAKERS CIR STE 115
POOLER, GA
31322-4168

Practice Phone: 912-988-1526
Practice Fax: 912-988-1537

1982555744 — EMPOWERED VIRTUAL SOLUTIONS, INC.
Practice Location Address:

103 CROSS CREEK DR
POOLER, GA
31322-9305

Practice Phone: 912-663-1047
Practice Fax:

Directions to “THE PLACE AT POOLER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.