ALTAMAHA PRIMARY CARE, LLC; NPI #1093472896

Contact Information

ALTAMAHA PRIMARY CARE, LLC

248 NE BROAD ST
JESUP, GA 31546-4371

Phone: 912-559-2696
Fax: 912-559-2420
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	363LP2300X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for ALTAMAHA PRIMARY CARE, LLC

NPI Number 1093472896

LBN Legal business name ALTAMAHA PRIMARY CARE, LLC

Authorized official KIMBERLY KIRK - (OWNER/PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/29/2021

Last updated 11/29/2021 - About 5 years ago

Identifiers

Medicaid

G07348B

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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ALTAMAHA PRIMARY CARE, LLC

Contact Information

Specialty

Primary Care

NPI Profile & details for ALTAMAHA PRIMARY CARE, LLC

Reviews for ALTAMAHA PRIMARY CARE, LLC