R T Stanley Health Center LLC
Clinic/Center, Rural Health in Lyons, GA. Organization (NPI-2).
NPI number1790778736
StatusActive
Last updated in NPPESAug 27, 2019
Details
- NPI
- 1790778736
- Entity type
- Organization (NPI-2)
- Legal business name
- R T Stanley Health Center LLC
- Organization subpart
- Yes
- Enumeration date
- Aug 24, 2005
- Last updated
- Aug 27, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | 138-476 | GA | Yes |
Other names
- R T Stanley Health Center LLC (Doing Business As)
Practice location
110 Rt Stanley Sr PlLyons, GA 30436-5623
Phone 912-526-9355 · Fax 912-526-8622
Mailing address
Po Box 407Vidalia, GA 30475-0407
Phone 912-537-4986 · Fax 912-526-8622
Authorized official
Tony M Osteen
Cfo
9125358691
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