Organization Name: | ACSH URGENT CARE OF GEORGIA, LLC |
NPI Number: | 1174943112 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NORMAN WINLAND (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 4861 Bill Gardner Pkwy Locust Grove |
State: | GA US |
Postal Code: | 302483644 |
Phone Number: | 7706265740 |
Fax Number: | 7706265765 |
NPI Enumeration Date: | 04/17/2014 |
NPI Last Update Date: | 08/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |