Providence Snf Operator LLC
Skilled Nursing Facility in Thomaston, GA. Organization (NPI-2).
NPI number1114448271
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1114448271
- Entity type
- Organization (NPI-2)
- Legal business name
- Providence Snf Operator LLC
- Organization subpart
- No
- Enumeration date
- Jun 29, 2017
- Last updated
- Jul 21, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART A PROVIDER - SKILLED NURSING FACILITY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | GA | Yes |
Practice location
1011 S Green StThomaston, GA 30286-4643
Phone 706-647-6693 · Fax 706-648-9255
Mailing address
1011 S Green StThomaston, GA 30286-4643
Phone 706-647-6693 · Fax 706-648-9255
Authorized official
Bruce E Wertheim
Manager
8133479888
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 6 Skilled Nursing Facility providers in Thomaston · All 280 providers in Thomaston
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