Bethany Home, Inc.

Organization Active NPI Skilled Nursing Facility · Vidalia, GA

NPI 1821057100 · NPPES record last updated Jan 13, 2010

Key facts

NPI
1821057100
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
1138015 (GA)
Legal business name
BETHANY HOME, INC.
Practice address
1305 East North St
Vidalia, GA 30474
Phone
(912) 537-7922
Fax
(912) 537-0216
NPI assigned
Mar 23, 2006
Organization subpart
No

Authorized official

Name
Sharron Winge
Title
Administrator
Phone
(912) 537-7922

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1138015 GA Yes

Addresses

Primary practice location

1305 East North St
Vidalia, GA 30474

Mailing address

1305 East North St
Vidalia, GA 30474
Phone (912) 537-7922

Other identifiers

IdentifierTypeStateIssuer
00140258BMedicaidGA
00140258AMedicaidGA

Other names

  • Bethany Nursing Center of Vidalia Doing business as

Other providers in Vidalia, GA

All providers in Vidalia, GA · Skilled Nursing Facility in Georgia

Sources for this page

Verify at the official NPI Registry.