Countryside Health Center

LBN: Countryside Nursing Llc
Countryside Health Center is an health care organization with primary practice located at 233 Carrollton St , Buchanan GA 30113-4917. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Countryside Nursing Llc can be contacted via phone (770) 646-3861, or through Tolson, Terry via phone (404) 644-0471.

Contact Information

Primary practice address
233 Carrollton St Buchanan GA 30113-4917
Phone: (770) 646-3861
Fax: (770) 646-3601
Website:
Map and Directions
Authorized official contact:
Name: Tolson, Terry
Phone: (404) 644-0471

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 1-071-2017 Georgia

Profile Details

NPI number 1114365657
LBN Legal business name Countryside Nursing Llc
DBA Doing business as Countryside Health Center
Authorized official Tolson, Terry
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2013
Last updated Sep 27th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114365657 NPPES
Georgia MEDICAID 000141666A

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