RESTORATION HEALTH CARE OF COMMERCE LLC NPI 1912079039

NPI Information

NPI: 1912079039
Provider Name: RESTORATION HEALTH CARE OF COMMERCE, LLC

Doing Business As: NORTHRIDGE MEDICAL CENTER

Classification: General Acute Care Hospital - 282NR1301X
Entity Type: Organization

Specialization: Rural

Address:
70 MEDICAL CENTER DRIVE
COMMERCE, GA
ZIP 30529
Phone: (706) 335-1000
Get Directions

RESTORATION HEALTH CARE OF COMMERCE, LLC is a rural general acute care hospital in Commerce, GA. RESTORATION HEALTH CARE OF COMMERCE, LLC NPI is 1912079039. The provider is registered as an organization entity type.
The provider Is Doing Business As Northridge Medical Center.

The provider's business location address is:

70 MEDICAL CENTER DRIVE
COMMERCE, GA
ZIP 30529
Phone: (706) 335-1000
Fax: (706) 335-7701

The provider's authorized official is Jerry Wise .
The authorized official title is Director and has the following contact phone number (706) 335-1101.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 8/12/2020.

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	Primary
1	273R00000X	Psychiatric Unit		No
2	275N00000X	Medicare Defined Swing Bed Unit		No
3	282NR1301X	General Acute Care Hospital	Rural	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	00000151A	MEDICAID	GEORGIA
2	000042	OTHER	GEORGIA	BLUE CROSS
3	00000151D	MEDICAID	GEORGIA
4	00000151S	MEDICAID	GEORGIA
5	00304059G	MEDICAID	GEORGIA
6	00808244A	MEDICAID	GEORGIA
7	00059331A	MEDICAID	GEORGIA
8	00559248C	MEDICAID	GEORGIA
9	191184	OTHER	GEORGIA	BLUE CROSS CRNA
10	852155	OTHER	GEORGIA	BLUE CROSS CLINIC

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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