National Provider Identifier Database

AUGUSTA ANTI AGING MEDICINE LLC
Family


Contact Information

AUGUSTA ANTI-AGING MEDICINE, LLC
610 PONDER PLACE DR
EVANS, GA30809-3185
Phone: 706-707-2808
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for AUGUSTA ANTI-AGING MEDICINE, LLC

NPI Number 1568047876
Legal business name
LBN
AUGUSTA ANTI-AGING MEDICINE, LLC
Authorized official SAMANTHA TOJINO - (SINGLE MEMBER)
Entity Organization
Organization subpart No
Enumeration date 03/17/2021
Last updated 03/17/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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