RESTORATION HEALTH CARE OF COMMERCE, LLC (NPI# 1912079039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912079039 |
| Entity Type | Organization |
| Organization Name | RESTORATION HEALTH CARE OF COMMERCE, LLC |
| Other Organization Name | NORTHRIDGE MEDICAL CENTER |
| Practice Address |
70 Medical Center Drive Commerce GA 30529 |
| Practice Telephone | 7063351000 |
| Practice Fax Number | 7063357701 |
| Mailing Telephone | 7063351120 |
| Mailing Fax Number | 7063356033 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | MR. JERRY WISE (DIRECTOR) |
| Authorized Official Telephone | 7063351101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273R00000X | Psychiatric Unit | Hospital Units | ||
| N | 275N00000X | Medicare Defined Swing Bed Unit | Hospital Units | ||
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00000151A | 05 | |
| GA | BLUE CROSS | 000042 | 01 |
| GA | 00000151D | 05 | |
| GA | 00000151S | 05 | |
| GA | 00304059G | 05 | |
| GA | 00808244A | 05 | |
| GA | 00059331A | 05 | |
| GA | 00559248C | 05 | |
| GA | BLUE CROSS CRNA | 191184 | 01 |
| GA | BLUE CROSS CLINIC | 852155 | 01 |
| Other Name | Type Code |
|---|---|
| Northridge Medical Center | Doing Business As Name - Organization |
| Street Address |
70 MEDICAL CENTER DRIVE |
| City | COMMERCE |
| State | GA |
| Zip Code | 30529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891249 | Himanshu Haridutt Desai | Pharmacist | 30983 Us-441 S, Commerce, GA 30529 | 2020-11-03 |
| 1477091155 | Joshua W. Upton | Pharmacist | 220 Hwy. 334, Commerce, GA 30529 | 2017-02-02 |
| 1881041853 | Le-nguyen, D.m.d., P.C. | Dentist | 119 Pottery Factory Drive, Commerce, GA 30529 | 2016-05-19 |
| 1104166800 | Ashley Hardigree Brueshaber | Nurse Practitioner | 1935 A Homer Rd, Suite A, Commerce, GA 30529 | 2013-02-18 |
| 1003179946 | Mary Allison Adams | Registered Nurse | 1935 Homer Rd Ste A, Commerce, GA 30529 | 2012-06-15 |
| 1386802155 | Urgent Care Banks Crossing LLC | Pain Medicine | 415 B Pottery Factory Drive, Commerce, GA 30529 | 2008-05-29 |
| 1841468287 | Ingles Markets Inc | Pharmacy | 220 Hwy 334, Commerce, GA 30529 | 2008-02-20 |
| 1548334758 | Advantage Bhs | Clinic/Center | 106 Industrial Pkwy, Commerce, GA 30529 | 2006-11-20 |
| 1023192325 | Thomas Arthur Wilber | Chiropractor | 30332 Highway 441 S, Commerce, GA 30529 | 2006-10-24 |
| 1194805689 | Brian Eugene Vandiver | Physical Therapist | 40095 Us Highway 441, Elite Physical Therapy, Commerce, GA 30529 | 2006-10-17 |
| Find all providers in zip 30529 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972969160 | Debra D Rathbun | General Acute Care Hospital | 192 Lobinger Ave, Fitzgerald, GA 31750-8181 | 2016-01-05 |
| 1326304486 | Ty Cobb Regional Medical Center LLC | General Acute Care Hospital | 367 Clear Creek Parkway, Lavonia, GA 30553 | 2012-04-03 |
| 1053400689 | Bacon Co. Health Services, Inc. | General Acute Care Hospital | 3406 Wildwood Ave., Patterson, GA 31557-5065 | 2006-10-12 |
| 1518051556 | Eugene Suarez Rodillo | General Acute Care Hospital | 111 South Webb Street, Hartwell, GA 30643 | 2006-10-03 |
| 1245248624 | Hospital Authority of Ben Hill | General Acute Care Hospital | 200 Perry House Rd, Fitzgerald, GA 31750-8857 | 2006-08-03 |
| 1700851649 | Crisp Regional Hospital Inc | General Acute Care Hospital | 902 7th St North, Cordele, GA 31010 | 2006-02-22 |
| 1558334334 | Mayo Clinic Health System In Waycross, Inc | General Acute Care Hospital | 1900 Tebeau Street, Waycross, GA 31501 | 2006-02-10 |
| 1588646251 | Wheeler County Hospital | General Acute Care Hospital | 111 N Third St, Glenwood, GA 30428-2301 | 2005-11-17 |
| 1952395097 | Southern Health Corp of Ellijay | General Acute Care Hospital | 1362 S Main St, 822 Industrial Blvd; 60 Old Highway 5 South, Ellijay, GA 30540-5410 | 2005-09-05 |
| 1588661672 | Americus & Sumter County Hospital Authority | General Acute Care Hospital | 100 Wheatley Dr, Americus, GA 31709-3788 | 2005-07-05 |
| 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.