Provider Demographics
NPI:1851425730
Name:VNA OF GREATER TIFT INC.
Entity Type:Organization
Organization Name:VNA OF GREATER TIFT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:GWALTNEY
Authorized Official - Last Name:ALBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-386-8571
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:2014 US HWY 41 N
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-0289
Mailing Address - Country:US
Mailing Address - Phone:229-386-8571
Mailing Address - Fax:229-386-1525
Practice Address - Street 1:2014 US HIGHWAY 41 N
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-2710
Practice Address - Country:US
Practice Address - Phone:229-386-8571
Practice Address - Fax:229-386-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA137-077251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000175117AMedicaid
GA000175117AMedicaid