Active NPI
Lowndes County Health Services, LLC
- Skilled Nursing Facility
- Valdosta, GA
National Provider Identifier
1659310662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1-092-939
- Legal business name
- LOWNDES COUNTY HEALTH SERVICES, LLC
- Practice address
- 413 Pendleton PL
Valdosta, GA 31602-2632 - Phone
- (229) 244-6968
- Fax
- (229) 247-9933
- NPI assigned
- Jun 5, 2006
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-092-939 | GA | Primary |
Addresses
Primary practice location
413 Pendleton PL
Valdosta, GA 31602-2632
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00141479A | Medicaid | GA |
Other names 1
- PruittHealth - Holly Hill
National Provider Directory
National Provider DirectoryNPI Registry JSON
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": "1659310662",
"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": "413 PENDLETON PL",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316022632",
"telephone_number": "229-244-6968",
"fax_number": "229-247-9933"
}
],
"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": "1-092-939",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00141479A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "PruittHealth - Holly Hill",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Valdosta, GA
- Lowndes Advocacy Resource Center, Inc
- Lowndes County Ambulatory Surgical Center
- Lowndes County Health Services LLC
- Lowndes County Health Services LLC
- Lowndes County Health Services, LLC
- Lowndes County Health Services, LLC
- Lowndes County Public Schools
- Nina Lui
- William Douglas Luke Jr., MD
- Leslie Lunney
Sources for this page
- 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.