Organization Name: | GEORGIA EMERGENCY ASSOCIATES IMMEDIATE CARE CENTER |
NPI Number: | 1699147421 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAM BASHLOR (OFFICE MANAGER) |
Mailing Address: | 3 Progressive St Bluffton |
State: | SC US |
Postal Code: | 299105165 |
Phone Number: | 8438159119 |
Fax Number: | 8438159121 |
NPI Enumeration Date: | 10/20/2015 |
NPI Last Update Date: | 10/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |