Provider Demographics
NPI:1093700205
Name:NIGHTINGALE ERS INC
Entity Type:Organization
Organization Name:NIGHTINGALE ERS INC
Other - Org Name:NIGHTINGALE DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:II
Authorized Official - Credentials:MBA
Authorized Official - Phone:912-355-6472
Mailing Address - Street 1:9100 WHITE BLUFF RD
Mailing Address - Street 2:STE 301
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4668
Mailing Address - Country:US
Mailing Address - Phone:912-354-3727
Mailing Address - Fax:912-691-4716
Practice Address - Street 1:9100 WHITE BLUFF RD
Practice Address - Street 2:STE 301
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4668
Practice Address - Country:US
Practice Address - Phone:912-354-3727
Practice Address - Fax:912-691-4716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000786002AMedicaid
GA000786002AMedicaid