PROVIDENT HEALTH SERVICES, INC.; NPI #1679634612

Contact Information

PROVIDENT HEALTH SERVICES, INC.

4700 WATERS AVE
SAVANNAH, GA 31404-6220

Phone: 912-350-8490
Fax: 912-350-8199
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Clinical Genetics (M.D.)	207SG0201X
Clinical Molecular Genetics	207SG0203X

Indicates primary specialty

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NPI Profile & details for PROVIDENT HEALTH SERVICES, INC.

NPI # 1679634612

LBN Legal business name PROVIDENT HEALTH SERVICES, INC.

Authorized official ROBIN MADDOX - (PROVIDER ENROLLMENT COORDINATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/13/2006

Last updated 11/12/2007 - About 19 years ago

Identifiers

Other

DF7661

RR MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PROVIDENT HEALTH SERVICES, INC.

Contact Information

Specialty

Clinical Genetics (M.D.)

Clinical Molecular Genetics

NPI Profile & details for PROVIDENT HEALTH SERVICES, INC.

Reviews for PROVIDENT HEALTH SERVICES, INC.