Provider Demographics
NPI:1962781914
Name:RESURGENCE HEALTH GROUP, LLC
Entity type:Organization
Organization Name:RESURGENCE HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:H
Authorized Official - Last Name:EASTMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:770-904-6731
Mailing Address - Street 1:1400 BUFORD HWY
Mailing Address - Street 2:D-1
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8721
Mailing Address - Country:US
Mailing Address - Phone:770-904-6731
Mailing Address - Fax:770-904-6734
Practice Address - Street 1:1400 BUFORD HWY
Practice Address - Street 2:D-1
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8721
Practice Address - Country:US
Practice Address - Phone:770-904-6731
Practice Address - Fax:770-904-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital