Southeast Lung & Critical Care Specialists
Organization Active NPI Sleep Specialist (PhD) · Brunswick, GA
NPI 1457501967 · NPPES record last updated Feb 17, 2010
Key facts
- NPI
- 1457501967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sleep Specialist (PhD) 173F00000X
- License
- 036358 (GA)
- Legal business name
- SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS
- Practice address
- 1111 Glynco Pkwy
Suite 410
Brunswick, GA 31525-7921 - Phone
- (912) 262-0611
- Fax
- (912) 262-0881
- NPI assigned
- Sep 22, 2008
- Organization subpart
- No
Authorized official
- Name
- April Young, ADMINISTRATION
- Title
- Administration
- Phone
- (912) 354-6614
Other NPIs on the same Medicare enrollment 33
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Specialist (PhD) |
173F00000X | 036358 | GA | Yes |
Addresses
Primary practice location
1111 Glynco Pkwy
Suite 410
Brunswick, GA 31525-7921
Mailing address
340 Eisenhower Dr
BLDG. 1500
Savannah, GA 31406-1600
Phone (912) 354-6614
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GRP3039 | Medicaid | GA |
Other providers in Brunswick, GA
- Southeast Georgia Health System, Inc.
- Southeast Georgia Health System, Inc.
- Southeast Georgia Hematology/Oncology Assoc.
- Southeast Georgia Open MRI LLC
- Southeast Georgia Urology Associates PC
- Southeast Lung & Critical Care Specialists, PC
- Southeast Second Chance, Inc
- Southeast Support Services
- Southeastern OB-GYN, P.C.
- Southeastern Pathology Associate
All providers in Brunswick, GA · Sleep Specialist (PhD) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2010. 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.