Provider Demographics
NPI:1851837934
Name:HZ SNF LLC
Entity type:Organization
Organization Name:HZ SNF LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WERTHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-347-9888
Mailing Address - Street 1:180 BURKETTS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31539-7132
Mailing Address - Country:US
Mailing Address - Phone:912-375-3677
Mailing Address - Fax:912-375-9974
Practice Address - Street 1:180 BURKETTS FERRY RD
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-7132
Practice Address - Country:US
Practice Address - Phone:912-375-3677
Practice Address - Fax:912-375-9974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115626Medicare Oscar/Certification