Vidalia Women's Center, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

VIDALIA WOMEN'S CENTER, LLC

Doing business as

Vidalia Women's Center

Practice address

101 Harris Industrial Blvd.
Suite C
Vidalia, GA 30474-8845

Phone

(912) 537-1014

Fax

(912) 538-0979

NPI assigned

Jun 21, 2007

Organization subpart

Yes

Parent organization

SOUTHEAST REGIONAL PRIMARY CARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Tony M Osteen

Title

Cfo

Phone

(912) 538-5314

Specialties & licenses 1

Addresses

Other names 1

• Vidalia Women's Center Doing business as

Part of

Southeast Regional Primary Care Corporation

Locations

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1952507592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD.",
            "address_2": "SUITE C",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748845",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "278 S Main St",
            "address_purpose": "LOCATION",
            "city": "Baxley",
            "state": "GA",
            "postal_code": "315130102",
            "country_code": "US",
            "telephone_number": "833-644-5433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1707 Meadows Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304747201",
            "country_code": "US",
            "telephone_number": "912-537-1014",
            "fax_number": "912-538-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIDALIA WOMEN'S CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
        "enumeration_date": "2007-06-21",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-538-5314"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vidalia Women's Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vidalia Women's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vidalia Pulmonology Center, LLC
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• Vidalia Surgical Associates, LLC
• Vidalia Urology Associates, LLC
• VPC, Inc. (Vidalia Pediatric Clinic)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0864)
• Wal-Mart Stores East, LP (Vision Center 30-0864)
• Lyndsay M Waldhour, RD, LD
• Walgreen Co (Walgreens #18184)

• Specialist in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.