SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.
Long Term Care Hospital
Riverdale, Georgia
Provider NPI: 1235227737
Organization Information:Organization Name: SOUTHERN CRESCENT HOSPITAL FOR SPECIALTY CARE, INC.
Practice Location:
11 UPPER RIVERDALE RD SW 6TH FLOOR RIVERDALE, GA 30274 US
Tel: 770-897-7603 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
11 UPPER RIVERDALE RD SW 6TH FLOOR RIVERDALE, GA 30274 US
Tel: 770-897-7603 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 282E00000X | Hospitals Long Term Care Hospital | GA | 031-614 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AETNA PIN | 7361505 | GA | 01 |
AETNA PVN | 3397399 | GA | 01 |
003109426A | GA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin