| Psychiatric Group Of The Coastal Empire, Inc. | |
|
4700 Waters Ave Savannah GA 31404-6220 | |
| (912) 350-4905 | |
| (912) 350-4955 |
| Full Name | Psychiatric Group Of The Coastal Empire, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4700 Waters Ave, Savannah, Georgia |
| Authorized Official Name and Position | Robin J. Maddox (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 9123509335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Group Of The Coastal Empire, Inc. Po Box 931979 Atlanta GA 31193-1968 Ph: (912) 350-4905 | Psychiatric Group Of The Coastal Empire, Inc. 4700 Waters Ave Savannah GA 31404-6220 Ph: (912) 350-4905 |
| NPI Number | 1598855355 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 01/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598855355 | NPI | - | NPPES |
| 3000032168A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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