Provider Demographics
NPI:1841652880
Name:SB HEALTHCARE, LLC
Entity type:Organization
Organization Name:SB HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RUDDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-649-3933
Mailing Address - Street 1:2262 MERRYMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2792
Mailing Address - Country:US
Mailing Address - Phone:770-649-3933
Mailing Address - Fax:678-298-8402
Practice Address - Street 1:2262 MERRYMOUNT DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2792
Practice Address - Country:US
Practice Address - Phone:770-649-3933
Practice Address - Fax:678-298-8402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based