1457412348 NPI number — HANCOCK COUNTY ASSOCIATION FOR RETARDED CHILDREN, INC.

Table of content: ERIN MICHELLE MINSTERMAN PHARMD (NPI 1063767838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457412348 NPI number — HANCOCK COUNTY ASSOCIATION FOR RETARDED CHILDREN, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HANCOCK COUNTY ASSOCIATION FOR RETARDED CHILDREN, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457412348
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 417
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPARTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31087-0417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-444-5989
Provider Business Mailing Address Fax Number:
706-444-6333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 BOLAND CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPARTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31087-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-444-5989
Provider Business Practice Location Address Fax Number:
706-444-6333
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIGGINS
Authorized Official First Name:
ANGELIA
Authorized Official Middle Name:
ANDREWS
Authorized Official Title or Position:
CENTER DIRECTOR
Authorized Official Telephone Number:
706-444-5989

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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