Provider Demographics
NPI:1699721399
Name:FLOYD HEALTHCARE MANAGEMENT INC
Entity type:Organization
Organization Name:FLOYD HEALTHCARE MANAGEMENT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF CORPORATE AND NETWORK SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-509-5000
Mailing Address - Street 1:420 E 2ND AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3209
Mailing Address - Country:US
Mailing Address - Phone:706-509-3200
Mailing Address - Fax:706-509-3201
Practice Address - Street 1:420 E 2ND AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3209
Practice Address - Country:US
Practice Address - Phone:706-509-3200
Practice Address - Fax:706-509-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057-047-H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000510485AMedicaid
GA111524Medicare ID - Type UnspecifiedMEDICARE BILLING NUMBER