Evans Memorial

Organization Active NPI Parenteral & Enteral Nutrition Supplies (DME) · Hawkinsville, GA

NPI 1972709772 · NPPES record last updated Jan 16, 2008

Key facts

NPI
1972709772
Entity type
Organization (NPI type 2)
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Legal business name
EVANS MEMORIAL
Practice address
440 Industrial Blvd
Hawkinsville, GA 31036
Phone
(478) 783-4988
NPI assigned
Jun 27, 2007
Organization subpart
Yes
Parent organization (as reported)
EVANS MEMORIAL HOSPITAL

Authorized official

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

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Evans Memorial (6 organizations share this tax ID)
Part of
Evans Memorial

Specialties & licenses

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

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

  • Glenvue Nursing Home Doing business as

Other providers in Hawkinsville, GA

All providers in Hawkinsville, GA · Parenteral & Enteral Nutrition Supplies (DME) in Georgia

Sources for this page

Verify at the official NPI Registry.