Basic Information
| Provider Information | |||||||||
| NPI: | 1164876272 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FLOYD HEALTHCARE MANAGEMENT, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ATRIUM HEALTH FLOYD URGENT CARE ROCKMART | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 E 2ND AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065093000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1650 CHATTAHOOCHEE DR | ||||||||
| Address2: | |||||||||
| City: | ROCKMART | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301532023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706846100 | ||||||||
| FaxNumber: | 7706847522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2016 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GORMAN | ||||||||
| AuthorizedOfficialFirstName: | MATTHEW | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP OF CORPORATE AND NETWORK SERVICE | ||||||||
| AuthorizedOfficialTelephone: | 7065095000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | 057556 | GA | Y | Suppliers | Non-Pharmacy Dispensing Site |
No ID Information.