Provider Demographics
NPI:1205401726
Name:ORCHARD HEALTH, LLC
Entity Type:Organization
Organization Name:ORCHARD HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:229-638-6726
Mailing Address - Street 1:201 W MCPHERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-2131
Mailing Address - Country:US
Mailing Address - Phone:229-638-6726
Mailing Address - Fax:229-518-4425
Practice Address - Street 1:201 W MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2131
Practice Address - Country:US
Practice Address - Phone:229-638-6726
Practice Address - Fax:229-518-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty