PROFESSIONAL RESOURCES MANAGEMENT OF RABUN LLC NPI 1326191180

NPI Information

NPI: 1326191180
Provider Name: PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC

Doing Business As: MOUNTAIN LAKES MEDICAL CENTER

Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
162 LEGACY PT
CLAYTON, GA
ZIP 30525
Phone: (706) 782-0401
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PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC is a critical access general acute care hospital in Clayton, GA. PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC NPI is 1326191180. The provider is registered as an organization entity type.
The provider Is Doing Business As Mountain Lakes Medical Center.

The provider's business location address is:

162 LEGACY PT
CLAYTON, GA
ZIP 30525-354
Phone: (706) 782-0401
Fax: (706) 782-0451

The provider's authorized official is Kristy Hall .
The authorized official title is Ceo and has the following contact phone number (706) 782-0400.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 8/8/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NC0060X	General Acute Care Hospital	Critical Access	119-621	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10063437	OTHER	GEORGIA	AMERIGROUP
2	293932	OTHER	GEORGIA	WELLCARE
3	00001559A	MEDICAID	GEORGIA
4	0001559S	MEDICAID	GEORGIA
5	51000340	OTHER	GEORGIA	BLUE CROSS OF GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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