Organization · Type 2 NPI

Hospital Authority of Liberty County

Skilled Nursing Facility · Ludowici, GA

NPI number 1265463004 Active

Practice location

Hwy 84 East
Ludowici, GA 31316

Call (912) 545-3392 Map

Fax (912) 545-9588

Mailing address

RR 3 Box 2D
Ludowici, GA 31316-9701

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

NPI record

NPI: 1265463004
Entity type: Organization (Type 2)
Issued: Jul 6, 2006
Last updated: Jan 6, 2022
Status: Active
Subpart: Yes of Hospital Authority of Liberty County

Other names

<unavail>
Coastal Manor Nursing Home · doing business as
Coastal Manor Nursing Home · doing business as

Authorized official

Derek Rozier
CFO
(912) 369-9427

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1265463004

Hospital Authority of Liberty County's National Provider Identifier is 1265463004, issued on Jul 6, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Ludowici, GA. The record was last updated on Jan 6, 2022.