EVANS MEMORIAL HOSPITAL, INC. (NPI# 1366461857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366461857 |
| Entity Type | Organization |
| Organization Name | EVANS MEMORIAL HOSPITAL, INC. |
| Other Organization Name | GLENVUE NURSING HOME |
| Practice Address |
721 N Downing Musgrove Hwy Glennville GA 30427-2208 |
| Practice Telephone | 9126542141 |
| Mailing Telephone | 9126542141 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARTHA F TATUM (CEO) |
| Authorized Official Telephone | 9127395105 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 11321521 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00141171A | 05 |
| Other Name | Type Code |
|---|---|
| GLENVUE NURSING HOME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861926438 | Evans Memorial Hospital, Inc. | Psychiatric Unit | 200 N River St, Claxton, GA 30417-1659 | 2017-04-20 |
| 1104350057 | Evans Memorial Hospital, Inc. | General Acute Care Hospital | 200 N River St, Claxton, GA 30417-1659 | 2017-04-18 |
| 1730110826 | Evans Memorial Hospital, Inc. | General Acute Care Hospital | 200 N River St, Claxton, GA 30417-1659 | 2006-07-06 |
| Street Address |
721 N DOWNING MUSGROVE HWY |
| City | GLENNVILLE |
| State | GA |
| Zip Code | 30427-2208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972097608 | Carlton Wendell Durrence IIi | Pharmacist | 15214 Us Highway 301, Glennville, GA 30427 | 2018-06-16 |
| 1790145258 | Lisa Dasher Anderson | Nurse Practitioner | 1000b North Veterans Boulevard, Glennville, GA 30427 | 2016-02-26 |
| 1902203722 | Kimberly Cason | Radiologic Technologist | 3945 Hwy 301, Glennville, GA 30427 | 2014-11-21 |
| 1598901696 | Jana Lamb Bunch | Nurse Practitioner | 1000 B. North Veterans Blvd, Glennville, GA 30427 | 2008-12-20 |
| 1407979420 | Sutton Place | Assisted Living Facility | 306 West Mann Street, Glennville, GA 30427 | 2007-04-06 |
| 1528192846 | Orthopedic Center PC | Orthopaedic Surgery | 601 S. Main St., Glennville, GA 30427 | 2007-03-16 |
| 1447339015 | Southern Medical Group | Internal Medicine | 601 S. Veterans Blvd, Glennville, GA 30427 | 2006-11-03 |
| 1154435550 | Roger W Beville | Family Medicine | 1000 B. North Veterans Boulevard, Glennville, GA 30427 | 2006-08-19 |
| 1265545115 | Sang Wan Oh | General Practice | 257 South Main Street, Reidsville, GA 30427 | 2006-08-16 |
| 1982613568 | Kenneth Lane Durrence | Physical Therapist | 104 W. Rustin St., Glennville, GA 30427 | 2006-08-05 |
| Find all providers in zip 30427 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861937187 | Organnizer | Nursing Facility/Intermediate Care Facility | 2320 Highway 20 Se, Conyers, GA 30013-2426 | 2016-12-22 |
| 1508228370 | Correcthealth Gdc, LLC | Nursing Facility/Intermediate Care Facility | 1 Bostick Cir, Milledgeville, GA 31062-7526 | 2016-03-22 |
| 1760856645 | 363l00000x | Nursing Facility/Intermediate Care Facility | 2171 Peachtree Rd Ne, Apt 306, Atlanta, GA 30309-6300 | 2015-11-16 |
| 1568846798 | Your Elite Companion Sitting and Healthcare Services | Nursing Facility/Intermediate Care Facility | 3235 Satellite Blvd, Bldg 400 Suite 300, Duluth, GA 30096-8687 | 2015-07-17 |
| 1194141549 | Hospital Authority of Valdosta and Lowndes County, Georgia | Nursing Facility/Intermediate Care Facility | 120 W Thigpen Ave, Lakeland, GA 31635-1011 | 2014-03-10 |
| 1255768024 | Department of Juvenile Justice | Nursing Facility/Intermediate Care Facility | 450 Crescent Dr, Gainesville, GA 30501-5079 | 2013-10-10 |
| 1043576812 | Call To Arm | Nursing Facility/Intermediate Care Facility | 4066 Christacy Way, Marietta, GA 30066-2786 | 2012-04-06 |
| 1881824928 | Tedla-kebede Corp | Nursing Facility/Intermediate Care Facility | 3424 Old Suttons Way, Marietta, GA 30062-4187 | 2009-07-23 |
| 1164642484 | Skidaway Health and Living Services, Inc. | Nursing Facility/Intermediate Care Facility | 95 Skidaway Island Park Rd, Savannah, GA 31411-1104 | 2007-04-27 |
| 1780798314 | Va Hospital | Nursing Facility/Intermediate Care Facility | 7264 Madison Circle, Union City, GA 30291 | 2006-08-19 |
| Find all providers with the same taxonomy | ||||
| City | GLENNVILLE |
| Zip Code | 30427 |
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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.