Lowndes County Health Services, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-092-937 Issued in GA

Legal business name

LOWNDES COUNTY HEALTH SERVICES, LLC

Doing business as

PruittHealth - Lakehaven

Practice address

410 Northside Dr
Valdosta, GA 31602-1802

Phone

(229) 242-7368

Fax

(229) 242-6126

NPI assigned

Jun 5, 2006

Last updated

Jul 2, 2014By 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

Neil L Pruitt Jr.

Title

Chairman and Ceo of Manager

Phone

(770) 279-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PruittHealth - Lakehaven Doing business as

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1568401578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 NORTHSIDE DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021802",
            "telephone_number": "229-242-7368",
            "fax_number": "229-242-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWNDES COUNTY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO OF MANAGER",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-092-937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00141721A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Lakehaven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacey L Lowery, MED, CCC-SLP
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• Lowndes County Ambulatory Surgical Center
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• Lowndes County Health Services LLC (Parkwood Development Center)
• Lowndes County Health Services, LLC (PruittHealth - Holly Hill)
• Lowndes County Health Services, LLC (PruittHealth - Valdosta)
• Lowndes County Public Schools
• Nina Lui
• William Douglas Luke Jr., MD

• Skilled Nursing Facility in Valdosta, GA
• Providers in Valdosta, 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 Jul 2, 2014; 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.