Provider Demographics
NPI:1053306191
Name:PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:PIEDMONT ATHENS REGIONAL MEDICAL CENTER, INC.
Other - Org Name:PIEDMONT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:706-316-2611
Mailing Address - Street 1:1550 TIMOTHY RD STE 201B
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7835
Mailing Address - Country:US
Mailing Address - Phone:833-719-1991
Mailing Address - Fax:706-475-5570
Practice Address - Street 1:1550 TIMOTHY RD STE 201B
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7835
Practice Address - Country:US
Practice Address - Phone:833-719-1991
Practice Address - Fax:706-475-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA029-233-H251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00814272AMedicaid
GA117125Medicare Oscar/Certification