Provider Demographics
NPI:1427057363
Name:PROFESSIONAL RESOURCE MGMT OF RABUN, LLC
Entity type:Organization
Organization Name:PROFESSIONAL RESOURCE MGMT OF RABUN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-782-0400
Mailing Address - Street 1:196 RIDGECREST CIR
Mailing Address - Street 2:SURGICAL SERVICE
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-4111
Mailing Address - Country:US
Mailing Address - Phone:706-782-4233
Mailing Address - Fax:706-782-0451
Practice Address - Street 1:196 RIDGECREST CIR
Practice Address - Street 2:SURGICAL SERVICE
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4111
Practice Address - Country:US
Practice Address - Phone:706-782-4233
Practice Address - Fax:706-782-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62897282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital