Renewal , Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

RENEWAL , INC

Doing business as

second to nature women's boutique

Practice address

818 Saint Sebastian Way
Ste 205
Augusta, GA 30901-2651

Phone

(706) 774-4155

Fax

(706) 774-4150

NPI assigned

Feb 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carla A Gober

Title

Ceo

Phone

(706) 774-4155

Specialties & licenses 1

Addresses

Other names 1

• second to nature women's boutique Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053446096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 SAINT SEBASTIAN WAY",
            "address_2": "STE 205",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012651",
            "telephone_number": "706-774-4155",
            "fax_number": "706-774-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SAINT SEBASTIAN WAY",
            "address_2": "STE 205",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012651",
            "telephone_number": "706-774-4155",
            "fax_number": "706-774-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOBER",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-774-4155",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "second to nature women's boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Augusta, GA
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• Prosthetic/Orthotic Supplier in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.