Provider Demographics
NPI:1174065601
Name:GOLD CITY HEALTH & REHAB LLC
Entity type:Organization
Organization Name:GOLD CITY HEALTH & REHAB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WINGET
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:478-994-3669
Mailing Address - Street 1:222 MOORES DR
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0441
Mailing Address - Country:US
Mailing Address - Phone:706-864-3045
Mailing Address - Fax:706-864-4535
Practice Address - Street 1:222 MOORES DR
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-0441
Practice Address - Country:US
Practice Address - Phone:706-864-3045
Practice Address - Fax:706-864-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
115689Medicare Oscar/Certification