Southeast Lung & Critical Care Specialists, PC
Organization Active NPI Pulmonary Disease Physician · Tybee Island, GA
NPI 1104346394 · NPPES record last updated Jun 20, 2017
Key facts
- NPI
- 1104346394
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- Legal business name
- SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC
- Practice address
- 7 Rosewood Ave
Tybee Island, GA 31328-9435 - Phone
- (912) 927-6270
- NPI assigned
- Jun 20, 2017
- Organization subpart
- No
Authorized official
- Name
- April Young
- Title
- Practice Administrator
- Phone
- (912) 721-5167
Other NPIs on the same Medicare enrollment 33
Corporate family (same tax ID) 39
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040415000176 | GA | Part B Supplier - Clinic/Group Practice | 7618962291 |
Receives reassigned benefits from 29 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Jesup, GA; Vidalia, GA; Tybee Island, GA; Sylvania, GA; Springfield, GA; Savannah, GA; Hinesville, GA; Brunswick, GA… |
National Provider Directory
- Tax ID family
- Southeast Lung Associates
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | Yes |
Addresses
Primary practice location
7 Rosewood Ave
Tybee Island, GA 31328-9435
Mailing address
PO Box 14417
Savannah, GA 31416-1417
Other names
- Southeast Lung Associates
Other providers in Tybee Island, GA
- Savannah Beach Healthcare & Rehab LLC
- SB Tybee LLC
- Renee Shamp
- Kimberley Simon
- Jessanna Elizabeth Smith
- Kristin Leo Swanson
- The Rosewood of Tybee Island of Journey LLC
- Tranquility Counseling Center, LLC
- Tybee Island Care Center LLC
- Tybee Island Trails of Journey LLC
All providers in Tybee Island, GA · Pulmonary Disease Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.