1780964841 NPI number — HINESVILLE WOMEN'S CLINIC

Table of content: DR. MICHAEL R RAMOS D.D.S. (NPI 1194733352)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780964841 NPI number — HINESVILLE WOMEN'S CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HINESVILLE WOMEN'S CLINIC
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:
1780964841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4540 E OGLETHORPE HWY
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
HINESVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31313-1445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-373-7035
Provider Business Mailing Address Fax Number:
912-369-2482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4540 E OGLETHORPE HWY
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
HINESVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31313-1445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-373-7035
Provider Business Practice Location Address Fax Number:
912-369-2482
Provider Enumeration Date:
08/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
MCLEOD
Authorized Official First Name:
CLIPHANE
Authorized Official Middle Name:
W
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
912-373-7035

Provider Taxonomy Codes

  • Taxonomy code: 302F00000X , with the licence number:  GA029212 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000336102A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com