1366796294 NPI number — N.A.T.S. NURSING ADULT TOTALCARE SERVICES

Table of content: (NPI 1366796294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366796294 NPI number — N.A.T.S. NURSING ADULT TOTALCARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
N.A.T.S. NURSING ADULT TOTALCARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366796294
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 1505
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMERICUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-942-9545
Provider Business Mailing Address Fax Number:
229-931-2797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 SOUTH GEORGIA TECH PARKWAY
Provider Second Line Business Practice Location Address:
BEC CENTER
Provider Business Practice Location Address City Name:
AMERICUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-942-9545
Provider Business Practice Location Address Fax Number:
229-931-2797
Provider Enumeration Date:
10/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
229-942-9545

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  129R0926 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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