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APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC NPI 1053772152


NPI Information

NPI: 1053772152
Provider Name: APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC

Other Name: APPLECARE POOLER

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
105 GRAND CENTRAL BLVD STE 108
POOLER, GA
ZIP 31322
Phone: (912) 748-1515
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APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC is a clinic center in Pooler, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). APPLECARE/MEMORIAL IMMEDIATE CARE JOINT VENTURE LLC NPI is 1053772152. The provider is registered as an organization entity type.
The provider Other Name Is Applecare Pooler.

The provider's business location address is:

105 GRAND CENTRAL BLVD STE 108
POOLER, GA
ZIP 31322-148
Phone: (912) 748-1515
Fax: (912) 748-7707

The provider's authorized official is Heidi D Nash .
The authorized official title is Administrative Coordinator and has the following contact phone number (912) 349-4945.

The enumeration date for this NPI number is 3/16/2016 and was last updated on 10/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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