Basic Information
| Provider Information | |||||||||
| NPI: | 1356444814 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FLOYD HEALTHCARE MANAGEMENT INC | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ATRIUM HEALTH FLOYD CHEROKEE EMERGENCY MEDICAL SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 RIVERSIDE PKWY NE | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301612902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065093820 | ||||||||
| FaxNumber: | 7068020960 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 RIVERSIDE PKWY NE | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301612902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065093820 | ||||||||
| FaxNumber: | 7065094791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 08/08/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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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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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | 057-01 | GA | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 000000756B | 05 | GA | MEDICAID |