Provider Demographics
NPI:1730529116
Name:PHNH LLC
Entity type:Organization
Organization Name:PHNH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHMAYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-650-7086
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:712 PATTERSON ST
Mailing Address - City:BYROMVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31007-0263
Mailing Address - Country:US
Mailing Address - Phone:478-433-5711
Mailing Address - Fax:478-433-4016
Practice Address - Street 1:712 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:BYROMVILLE
Practice Address - State:GA
Practice Address - Zip Code:31007-0263
Practice Address - Country:US
Practice Address - Phone:478-433-5711
Practice Address - Fax:478-433-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115564Medicare Oscar/Certification