Nutrisource Nutritional Services, Inc. is a
Dietitian, Registered based in Saint Simons Island, Georgia. Nutrisource Nutritional Services, Inc. is licensed to practice in Georgia (license number LD002579) and their current practice location is
504 Beachview Dr, Suite 2a, Saint Simons Island, Georgia. It can be reached at their office (for appointments etc.) via phone at
(912) 222-7755.
NPI number for Nutrisource Nutritional Services, Inc. is 1932486966 and their current mailing address is 620 Sea Island Rd, Pmb 273, Saint Simons Island, Georgia. Nutrisource Nutritional Services, Inc.
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1932486966.
Healthcare Provider's Profile
Full Name | Nutrisource Nutritional Services, Inc. |
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Type | Facility |
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Speciality | Dietitian, Registered |
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Location | 504 Beachview Dr, Saint Simons Island, Georgia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1932486966
- Provider Enumeration Date: 11/04/2011
- Last Update Date: 11/04/2011
Medical Identifiers
Medical identifiers for Nutrisource Nutritional Services, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1932486966 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LD002579 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nutrisource Nutritional Services, Inc. is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Nutrisource Nutritional Services, Inc. 620 Sea Island Rd, Pmb 273, Saint Simons Island, GA 31522-1767 Ph: (912) 222-7755 | Nutrisource Nutritional Services, Inc. 504 Beachview Dr, Suite 2a, Saint Simons Island, GA 31522-4740 Ph: (912) 222-7755 |
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