Wyld Lillies Crown

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WYLD LILLIES CROWN

Practice address

2763 Tobacco Rd Ste E
Hephzibah, GA 30815-7051

Phone

(706) 726-5406

NPI assigned

Apr 10, 2023

Organization subpart

No

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

Authorized official

Name

Miriam JenningsNPI 1902524234

Title

Owner

Phone

(706) 726-5406

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miriam Jennings

  • Specialist
  • Hephzibah, GA
  • NPI 1902524234
  NPD Authorized official

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1649965286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 DEEN AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063232",
            "telephone_number": "706-726-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2763 TOBACCO RD STE E",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308157051",
            "telephone_number": "706-726-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYLD LILLIES CROWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-726-5406"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tchelynda Brianne Wimberly
• Tamara Worthy, LMSW
• Santredra F Wright, REGISTERED NURSE
• Tiffany Banks Wright, NP
• Janye Wyche
• Hyun Min Yoo
• Jacqueline Claudia Young, PHT, CCMA,

• Durable Medical Equipment & Medical Supplies in Hephzibah, GA
• Providers in Hephzibah, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.