Provider Demographics
NPI:1164628962
Name:STROUD, INCORPORATED
Entity Type:Organization
Organization Name:STROUD, INCORPORATED
Other - Org Name:GIBSON HEALTH & REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PART B BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-783-4988
Mailing Address - Street 1:440 INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036
Mailing Address - Country:US
Mailing Address - Phone:478-783-4988
Mailing Address - Fax:
Practice Address - Street 1:440 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036
Practice Address - Country:US
Practice Address - Phone:478-783-4988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1254880002Medicare NSC