Basic Information
Provider Information
NPI: 1780617985
EntityType: 2
ReplacementNPI:  
OrganizationName: SYLVESTER HEALTH CARE, INC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 385
Address2:  
City: ALBANY
State: GA
PostalCode: 317020385
CountryCode: US
TelephoneNumber: 2296390021
FaxNumber: 2296390081
Practice Location
Address1: 104 MONK ST
Address2:  
City: SYLVESTER
State: GA
PostalCode: 317917246
CountryCode: US
TelephoneNumber: 2297765541
FaxNumber: 2297769712
Other Information
ProviderEnumerationDate: 07/09/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: KING
AuthorizedOfficialFirstName: DAVIS
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2296390021
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X1159702GAY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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