Provider Demographics
NPI:1174916027
Name:NIGHTINGALES MEDICAL AGENCY
Entity type:Organization
Organization Name:NIGHTINGALES MEDICAL AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERRARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-839-3993
Mailing Address - Street 1:PO BOX 773
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-0773
Mailing Address - Country:US
Mailing Address - Phone:877-839-3993
Mailing Address - Fax:877-839-3993
Practice Address - Street 1:889 SHORT ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-6155
Practice Address - Country:US
Practice Address - Phone:877-839-3993
Practice Address - Fax:877-839-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care