Provider Demographics
NPI:1720719875
Name:THOMASVILLE OPERATIONS LLC
Entity Type:Organization
Organization Name:THOMASVILLE OPERATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:S
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-368-4402
Mailing Address - Street 1:120 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-2507
Mailing Address - Country:US
Mailing Address - Phone:229-225-1049
Mailing Address - Fax:
Practice Address - Street 1:120 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31757-2507
Practice Address - Country:US
Practice Address - Phone:229-225-1049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility