NPIMap

Organization Active NPI

Evans Memorial

Doing business as Glenvue Nursing Home

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Hawkinsville, GA
National Provider Identifier
1972709772
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
Legal business name
EVANS MEMORIAL
Doing business as
Glenvue Nursing Home
Practice address
440 Industrial Blvd
Hawkinsville, GA 31036
Phone
(478) 783-4988
NPI assigned
Jun 27, 2007
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
EVANS MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Danny S Lynn
Title
Administrator
Phone
(912) 654-2138

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility Supplies (DME) 332BN1400X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X Primary

Addresses

Primary practice location

440 Industrial Blvd
Hawkinsville, GA 31036

Mailing address

PO Box 1033
Hawkinsville, GA 31036-7033
Phone (478) 783-4988

Other names 1

  • Glenvue Nursing Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evans Memorial Hosp Inc6 organizations share this tax ID, including this one
Part of
Evans Memorial Hosp Inc

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1972709772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1033",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310367033",
            "telephone_number": "478-783-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 INDUSTRIAL BLVD",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "31036",
            "telephone_number": "478-783-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS MEMORIAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANS MEMORIAL HOSPITAL",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "DANNY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "912-654-2138"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenvue Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hawkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.