1750927166 NPI number — G AND B MEDICAL LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750927166 NPI number — G AND B MEDICAL LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G AND B MEDICAL LLC
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:
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:
1750927166
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9801
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31908-0801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-593-8097
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001-12 SOUTH LUMPKIN RD SUITE 12
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31903-3190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-221-9823
Provider Business Practice Location Address Fax Number:
706-221-9816
Provider Enumeration Date:
11/20/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JAMES-POSEY
Authorized Official First Name:
GERALDA
Authorized Official Middle Name:
ANDREA
Authorized Official Title or Position:
PROVIDER/CEO
Authorized Official Telephone Number:
706-221-9823

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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