Great State 2019 Inc

LBN: Great State 2019 Inc
Great State 2019 Inc is an health care organization with primary practice located at 4960 Rice Mine Rd Ne Ste 30A , Tuscaloosa AL 35406-3136. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Great State 2019 Inc can be contacted via phone (205) 509-9055, or through Sparkman, Daniel via phone (205) 509-9055.

Contact Information

Primary practice address
4960 Rice Mine Rd Ne Ste 30A Tuscaloosa AL 35406-3136
Phone: (205) 509-9055
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Sparkman, Daniel
Phone: (205) 509-9055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1124757588
LBN Legal business name Great State 2019 Inc
DBA Doing business as
Authorized official Sparkman, Daniel
Entity Organization
Organization subpart 1 No
Enumeration date Jun 9th, 2022
Last updated Jun 9th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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