Provider Demographics
NPI:1861787830
Name:NURSING HOME SPECIALISTS, L.L.C.
Entity type:Organization
Organization Name:NURSING HOME SPECIALISTS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:FOUCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-747-0732
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:SMARR
Mailing Address - State:GA
Mailing Address - Zip Code:31086-0325
Mailing Address - Country:US
Mailing Address - Phone:478-747-0732
Mailing Address - Fax:478-992-6737
Practice Address - Street 1:201 ESSEX PL
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-8293
Practice Address - Country:US
Practice Address - Phone:478-747-0732
Practice Address - Fax:478-992-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1531208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty