Arrowhead Healthcare, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-031-1598 Issued in GA

Legal business name

ARROWHEAD HEALTHCARE, LLC

Practice address

239 Arrowhead Blvd
Jonesboro, GA 30236-1101

Phone

(770) 478-3013

Fax

(770) 478-3446

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Tygh Brogdon

Title

Manager

Phone

(770) 650-8773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Arrowhead Healthcare Doing business as

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1316914302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "30236",
            "telephone_number": "770-478-3013",
            "fax_number": "770-478-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361101",
            "telephone_number": "770-478-3013",
            "fax_number": "770-478-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARROWHEAD HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "TYGH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-650-8773"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-031-1598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00143162A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arrowhead Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.