<Unavail>
LBN: Provident Health Services, Inc.
<Unavail> is an health care organization with primary practice located at 4700 Waters Ave Memorial Health Hospitalists, Savannah GA 31404-6220. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is the primary health care specialty.
Provident Health Services, Inc. can be contacted via phone (912) 350-2155, or through Maddox, Robin J. via phone (912) 350-9335.
Contact Information
Primary practice address
4700 Waters Ave Memorial Health Hospitalists
Savannah GA 31404-6220
Phone: (912) 350-2155
Fax: (912) 350-2156
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X |
Profile Details
| NPI number | 1740341783 |
|---|---|
| LBN Legal business name | Provident Health Services, Inc. |
| DBA Doing business as | <Unavail> |
| Authorized official | Maddox, Robin J. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Jun 4th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740341783 | NPPES |
| South Carolina | Other | DF7661 | RR MEDICARE |
| South Carolina | MEDICAID | 609293670A | RR MEDICARE |
| South Carolina | Other | DA3772 | RR MEDICARE |
| South Carolina | MEDICAID | GPA921 | RR MEDICARE |
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