Elite Medical Center, LLC
Clinic/Center, Primary Care in Pooler, GA. Organization (NPI-2).
NPI number1982207437
StatusActive
Last updated in NPPESNov 18, 2020
Details
- NPI
- 1982207437
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Medical Center, LLC
- Organization subpart
- No
- Enumeration date
- Nov 18, 2020
- Certification date
- Nov 18, 2020
- Last updated
- Nov 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
114 Canal St Ste 201Pooler, GA 31322-4260
Phone 912-988-3839
Mailing address
114 Canal St Ste 201Pooler, GA 31322-4260
Phone 912-988-3839 · Fax 912-988-3839
Authorized official
David A Jackson
President/Owner
9129883839
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