Southern Traditions
LBN: Sovereign Healthcare Of Buchanan, Llc
Southern Traditions is an health care organization with primary practice located at 144 Depot St , Buchanan GA 30113-5216. 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.
Sovereign Healthcare Of Buchanan, Llc can be contacted via phone (770) 646-5512, or through Cronquist, R. Mark via phone (404) 574-2100.
Contact Information
Primary practice address
144 Depot St
Buchanan GA 30113-5216
Phone: (770) 646-5512
Fax: (770) 646-5591
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 1-071-1896 | Georgia |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 1-071-1897 | Georgia |
Profile Details
| NPI number | 1609070853 |
|---|---|
| LBN Legal business name | Sovereign Healthcare Of Buchanan, Llc |
| DBA Doing business as | Southern Traditions |
| Authorized official | Cronquist, R. Mark |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 12th, 2007 |
| Last updated | Sep 24th, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609070853 | NPPES |
| Georgia | MEDICAID | 000142722A |
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