NPIMap

Organization Active NPI

Clinch Healthcare LLC

  • Skilled Nursing Facility
  • Homerville, GA
National Provider Identifier
1689614935
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-032-1862 Issued in GA
Legal business name
CLINCH HEALTHCARE LLC
Practice address
390 Sweat St
Homerville, GA 31634-2302
Phone
(912) 487-5328
Fax
(912) 487-2460
NPI assigned
Jun 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-032-1862 GA Primary

Addresses

Primary practice location

390 Sweat St
Homerville, GA 31634-2302

Mailing address

390 Sweat St
Homerville, GA 31634-2302
Phone (912) 487-5328

Other identifiers 1

IdentifierTypeStateIssuer
000142106AMedicaidGA

Other names 1

  • Clinch HealthCare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1689614935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 SWEAT ST",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342302",
            "telephone_number": "912-487-5328",
            "fax_number": "912-487-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 SWEAT ST",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316342302",
            "telephone_number": "912-487-5328",
            "fax_number": "912-487-2460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINCH HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "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": "1-032-1862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000142106A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinch HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Homerville, GA

Sources for this page

  • 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.