PRUITTHEALTH HOSPICE, INC. (NPI# 1154369247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154369247 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH HOSPICE, INC. |
| Other Organization Name | PRUITTHEALTH HOSPICE - CORDELE |
| Practice Address |
708 E 16th Ave Cordele GA 31015-1512 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 2292710300 |
| Mailing Telephone | 7702796200 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-07-07 |
| Authorized Official Name | NEIL L PRUITT JR. (CHAIRMAN AND CEO) |
| Authorized Official Telephone | 7702796200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00849736A | 05 |
| Other Name | Type Code |
|---|---|
| PruittHealth Hospice - Cordele | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386036473 | Pruitthealth Hospice, Inc. | Hospice, Inpatient | 2944 Breezewood Avenue, Suite 102, Fayetteville, NC 28303-5415 | 2015-02-26 |
| 1881983419 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 902 West D St, Ste B, North Wilkesboro, NC 28659 | 2011-04-05 |
| 1265761118 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 903 Elmwood Avenue, Suites A and B, Columbia, SC 29201-2066 | 2009-12-23 |
| 1790915320 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 1 Poston Road, Suite 238, Charleston, SC 29401-3463 | 2009-07-16 |
| 1184860306 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 102 East Curtis Street, Simpsonville, SC 29681-2620 | 2008-12-17 |
| 1003996711 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 171 Church St, Suite 210, Charleston, SC 29401-3135 | 2006-10-17 |
| 1750329116 | Pruitthealth Hospice, Inc. | Hospice, Inpatient | 810 Kennedy Avenue, New Bern, NC 28560 | 2006-06-04 |
| 1841238441 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 35 Three Rivers Dr Ne, Rome, GA 30161-4998 | 2006-06-04 |
| 1992744361 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 2313 Executive Cir Ste A, Greenville, NC 27834 | 2006-06-04 |
| 1902844830 | Pruitthealth Hospice, Inc. | Hospice Care, Community Based | 609 S Coit St, Florence, SC 29501-5222 | 2006-06-03 |
| Street Address |
708 E 16TH AVE |
| City | CORDELE |
| State | GA |
| Zip Code | 31015-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407385032 | Randall Benjamin Forehand | Nurse Practitioner | 708 E 16th Ave, Cordele, GA 31015-1512 | 2017-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618164 | Jeffrey Allen Wessel Jr. | Physical Therapist | 1107b Greer Street, Cordele, GA 31015 | 2020-08-03 |
| 1316502024 | Clifton Anthony Jordan | Specialist | 1106 East Ave Suite J, Cordele, GA 31015 | 2019-05-08 |
| 1336678440 | Robert Kenneth Lancaster | Dentist | 604 E 15th Avenue, Cordele, GA 31015 | 2017-06-12 |
| 1457602435 | Marvin Tolbert Mcafee IIi | Physician Assistant | 416 East 4th Ave, Suite B, Cordele, GA 31015 | 2012-10-01 |
| 1568719169 | Kimberly Bertelson | Physical Therapy Assistant | 1107 Greer Street, Suite B, Cordele, GA 31015 | 2012-08-14 |
| 1134474174 | R W Leitner Od LLC | Optometrist | 716-c 16th Ave East, Cordele, GA 31015 | 2012-07-16 |
| 1790048023 | Holly K Davis | Nurse Practitioner | 602 E 16th Ave Ste B, Cordele, GA 31015 | 2012-06-21 |
| 1508141482 | Beatrice Hurt Mckee | Nurse Practitioner | 216 Hospital Drive., Cordele, GA 31015 | 2011-10-11 |
| 1669784393 | Elisabeth R Waldrip | Dentist | 115 E 14th Avenue, Cordele, GA 31015 | 2010-07-10 |
| 1063656403 | Priscilla George Thomas | Surgery | 416 E 4th Ave # A, Cordele, GA 31015 | 2009-04-29 |
| Find all providers in zip 31015 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699740498 | Crisp Regional Hospital, Inc | Hospice Care, Community Based | 910 N 5th St, Cordele, GA 31015-3254 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153492 | Legacy Hospice Ga | Hospice Care, Community Based | 1700 Frederica Rd Ste 205, St Simons Island, GA 31522-2583 | 2020-10-28 |
| 1013515030 | Perimeter Hospice of Georgia | Hospice Care, Community Based | 150 Stanley Ct Ste E, Lawrenceville, GA 30046-5215 | 2020-10-12 |
| 1780291039 | Goldencare Hospice and Palliative Care | Hospice Care, Community Based | 7555 Bridgegate Ct, Sandy Springs, GA 30350-4604 | 2020-09-29 |
| 1255947651 | Community Hospice of Georgia | Hospice Care, Community Based | 321 N Main St Ste A, Adairsville, GA 30103-2403 | 2020-09-21 |
| 1437762382 | Allaway Angels | Hospice Care, Community Based | 805 Deerfield Ct, Stone Mountain, GA 30087-5483 | 2020-08-28 |
| 1144832494 | Circle of Hope Hospice | Hospice Care, Community Based | 5750 Brook Hollow Pkwy Ste 105, Norcross, GA 30071-3515 | 2020-08-18 |
| 1518578335 | Jaslinks Hospice Inc | Hospice Care, Community Based | 2282 Meadow Church Rd Ste 300, Duluth, GA 30097-5318 | 2020-08-14 |
| 1104434570 | An Angels Touch Hospice LLC | Hospice Care, Community Based | 2345 4th St Ste 600d, Tucker, GA 30084-8518 | 2020-07-21 |
| 1609494327 | Divine Guardian LLC | Hospice Care, Community Based | 2321 4th St Ste 210, Tucker, GA 30084-8516 | 2020-07-09 |
| 1184242026 | Champions Nursing Services, LLC | Hospice Care, Community Based | 2365 Wall St Se Ste 210, Conyers, GA 30013-2197 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.