Provider Demographics
NPI:1164465787
Name:UNADILLA HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:UNADILLA HEALTH CARE CENTER INC
Other - Org Name:UNAHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-627-3263
Mailing Address - Street 1:2858 PINE STREET
Mailing Address - Street 2:P. O. BOX 446
Mailing Address - City:UNADILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31091
Mailing Address - Country:US
Mailing Address - Phone:478-627-3263
Mailing Address - Fax:478-627-9714
Practice Address - Street 1:2858 PINE STREET
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:GA
Practice Address - Zip Code:31091
Practice Address - Country:US
Practice Address - Phone:478-627-3263
Practice Address - Fax:478-627-9714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11-1888 (GRP7631)Medicare ID - Type Unspecified