Provider Demographics
NPI:1669699708
Name:LILLIE'S NURSING SERVICE
Entity type:Organization
Organization Name:LILLIE'S NURSING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-507-3638
Mailing Address - Street 1:PO BOX 8375
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8375
Mailing Address - Country:US
Mailing Address - Phone:706-507-3638
Mailing Address - Fax:706-507-3640
Practice Address - Street 1:5051 WARM SPRINGS RD
Practice Address - Street 2:SUITE B-1
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4157
Practice Address - Country:US
Practice Address - Phone:706-507-3638
Practice Address - Fax:706-507-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106-R-0242251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health