Provider Demographics
NPI:1356674709
Name:MERIWETHER HEALTHCARE, L.L.C.
Entity Type:Organization
Organization Name:MERIWETHER HEALTHCARE, L.L.C.
Other - Org Name:WARM SPRINGS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-655-9351
Mailing Address - Street 1:5995 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830-2149
Mailing Address - Country:US
Mailing Address - Phone:706-655-3331
Mailing Address - Fax:706-655-9266
Practice Address - Street 1:5995 SPRING ST
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830-2149
Practice Address - Country:US
Practice Address - Phone:706-655-3331
Practice Address - Fax:706-655-9266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2017-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE008857333600000X
GAPHH0077633336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000001284BMedicaid
GA5939900001Medicare PIN