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WIDE RANGE OF RESOURCES INC NPI 1043459878


NPI Information

NPI: 1043459878
Provider Name: WIDE RANGE OF RESOURCES, INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1776 N JEFFERSON ST NE
SUITE B
MILLEDGEVILLE, GA
ZIP 31061
Phone: (478) 451-3112
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WIDE RANGE OF RESOURCES, INC is a clinic center in Milledgeville, 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). WIDE RANGE OF RESOURCES, INC NPI is 1043459878. The provider is registered as an organization entity type.

The provider's business location address is:

1776 N JEFFERSON ST NE
SUITE B
MILLEDGEVILLE, GA
ZIP 31061-229
Phone: (478) 451-3112
Fax: (478) 451-0626

The provider's authorized official is Frezalia L. Oliver .
The authorized official title is Clinical Director and has the following contact phone number (478) 451-3112.

The enumeration date for this NPI number is 2/18/2009 and was last updated on 2/18/2009.


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/CenterCSW00658GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP7368OTHERGEORGIAMEDICARE GROUP PIN
2R61751MEDICARE UPINGEORGIA
3139858482BMEDICAIDGEORGIA
4538773445AMEDICAIDGEORGIA
5139858482CMEDICAIDGEORGIA
6139858482AMEDICAIDGEORGIA
780BBGLVMEDICARE PINGEORGIA

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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