Provider Demographics
NPI:1215921713
Name:WARE COUNTY HEALTH CARE LLC
Entity type:Organization
Organization Name:WARE COUNTY HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAXIC
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-285-4721
Mailing Address - Street 1:1910 DOROTHY ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-7161
Mailing Address - Country:US
Mailing Address - Phone:912-638-7275
Mailing Address - Fax:912-638-7756
Practice Address - Street 1:1910 DOROTHY ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-7161
Practice Address - Country:US
Practice Address - Phone:912-285-4721
Practice Address - Fax:912-285-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-148-949314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000143459AMedicaid
GA000143459AMedicaid