| House Calls Of Coastal Georgia, Pc | |
|
811 Sand Dollar Trce St Simons Island GA 31522-3761 | |
| (912) 580-6913 | |
| (912) 265-2859 |
| Full Name | House Calls Of Coastal Georgia, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 811 Sand Dollar Trce, St Simons Island, Georgia |
| Authorized Official Name and Position | Ismael Salim Osta (MANAGER) |
| Authorized Official Contact | 9125816913 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| House Calls Of Coastal Georgia, Pc 811 Sand Dollar Trce St Simons Island GA 31522-3761 Ph: (912) 580-6913 | House Calls Of Coastal Georgia, Pc 811 Sand Dollar Trce St Simons Island GA 31522-3761 Ph: (912) 580-6913 |
| NPI Number | 1134467533 |
|---|---|
| Provider Enumeration Date | 01/21/2013 |
| Last Update Date | 09/19/2013 |
| Medicare PECOS PAC ID | 4688818107 |
|---|---|
| Medicare Enrollment ID | O20130923000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134467533 | NPI | - | NPPES |
| 021787368C | Medicaid | GA | |
| 00069297A3 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15631 (* (Not Available)) | Primary |
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