4Front Healthcare of Middle Georgia, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

4FRONT HEALTHCARE OF MIDDLE GEORGIA, LLC

Practice address

682 1St St
Macon, GA 31201

Phone

(877) 313-8928

Fax

(877) 857-3217

NPI assigned

Sep 25, 2015

Last updated

Jul 6, 2018By 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

Raina Owens

Title

Senior VP

Phone

(912) 226-3035

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1316317993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 WATERS AVE STE F8",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063822",
            "telephone_number": "877-313-8928",
            "fax_number": "877-857-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "877-313-8928",
            "fax_number": "877-857-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4FRONT HEALTHCARE OF MIDDLE GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "RAINA",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "912-226-3035"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.