Bacchus Operations Group, Inc

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

094391 Issued in GA

Legal business name

BACCHUS OPERATIONS GROUP, INC

Practice address

502 Sumter St
Suite B
Montezuma, GA 31063-1734

Phone

(478) 472-8178

Fax

(478) 472-3289

NPI assigned

Oct 1, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Philip H Eastman, III

Title

Ceo

Phone

(770) 904-6731

Specialties & licenses 1

Addresses

Other names 1

• Flint River Urgent Care Doing business as

Locations

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1184051567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 SUMTER ST",
            "address_2": "SUITE B",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631734",
            "telephone_number": "478-472-8178",
            "fax_number": "478-472-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 SUMTER ST",
            "address_2": "SUITE B",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631734",
            "telephone_number": "478-472-8178",
            "fax_number": "478-472-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACCHUS OPERATIONS GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "EASTMAN, III",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-904-6731",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "094391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flint River Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bacchus Operations Group, Inc
• Bacchus Operations Group, Inc.
• Bacchus Operations Group, Inc.
• Bacchus Operations Group, Inc.
• Bacchus Operations Group, Inc.
• Bridget April Barrow, NP

• Urgent Care Clinic/Center in Montezuma, GA
• Providers in Montezuma, GA by specialty
• Urgent Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.