Miona Geriatric and Dementia Center, LLC

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

MIONA GERIATRIC AND DEMENTIA CENTER, LLC

Practice address

201 Poplar St
Ideal, GA 31041-6264

Phone

(478) 949-2270

NPI assigned

Aug 19, 2008

Last updated

Oct 27, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William Jule Windham

Title

President

Phone

(478) 967-2223

Specialties & licenses 1

Addresses

Tax ID family

Magnolia Manor of Macon County Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Miona Geriatric & Dementia Center, LLC

  • Skilled Nursing Facility
  • Ideal, GA
  • NPI 1215919709
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1174770424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 NURSING HOME RD",
            "city": "MARSHALLVILLE",
            "state": "GA",
            "postal_code": "310573715",
            "telephone_number": "478-967-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 POPLAR ST",
            "city": "IDEAL",
            "state": "GA",
            "postal_code": "310416264",
            "telephone_number": "478-949-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIONA GERIATRIC AND DEMENTIA CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "WINDHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JULE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-967-2223"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Dodson Gay, OTA
• Gina Maria Hartigan
• Miona Geriatric & Dementia Center, LLC
• Christopher Richards, M.D.

• Parenteral & Enteral Nutrition Supplies (DME) in Ideal, GA
• Providers in Ideal, GA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.