South Georgia Health Group LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

041178 Issued in GA

Legal business name

SOUTH GEORGIA HEALTH GROUP LLC

Practice address

3215 N Oak Street Ext Ste D
Valdosta, GA 31605-7439

Phone

(229) 259-9962

Fax

(229) 259-9941

NPI assigned

Jan 13, 2011

Organization subpart

No

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

Authorized official

Name

Douglas Moss, MD

Title

Owner

Phone

(229) 259-9962

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1861797474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021398",
            "telephone_number": "229-259-9962",
            "fax_number": "229-259-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N OAK STREET EXT STE D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057439",
            "telephone_number": "229-259-9962",
            "fax_number": "229-259-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA HEALTH GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-259-9962",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "041178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Georgia Eye Partners PC
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• South Georgia Family Medicine
• South Georgia Health Alliance Dba Hospice of South Georgia
• South Georgia Health Group LLC
• South Georgia Health Group, LLC
• South Georgia Medical Associates, PC
• South Georgia Medical Center
• South Georgia Medical Center
• South Georgia Medical Center

• Durable Medical Equipment & Medical Supplies in Valdosta, GA
• Providers in Valdosta, 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 Jan 19, 2011; 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.