| R T Stanley Health Center Llc | |
|
110 Rt Stanley Sr Pl Lyons GA 30436-5623 | |
| (912) 526-9355 | |
| (912) 526-8622 |
| Full Name | R T Stanley Health Center Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 110 Rt Stanley Sr Pl, Lyons, Georgia |
| Authorized Official Name and Position | Tony M Osteen (CFO) |
| Authorized Official Contact | 9125358691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R T Stanley Health Center Llc Po Box 407 Vidalia GA 30475-0407 Ph: (912) 537-4986 | R T Stanley Health Center Llc 110 Rt Stanley Sr Pl Lyons GA 30436-5623 Ph: (912) 526-9355 |
| NPI Number | 1790778736 |
|---|---|
| Provider Enumeration Date | 08/24/2005 |
| Last Update Date | 08/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790778736 | NPI | - | NPPES |
| 11-8904 | Other | GA | MEDICARE ID-TYPE UNSPECIFIED |
| 0003111970A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 138-476 (Georgia) | Primary |
Lyons Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Moody Cir, Lyons, GA 30436 Phone: 912-526-6567 Fax: 912-526-0471 | |
Lyons Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Moody Cir, Lyons, GA 30436 Phone: 912-526-0073 |