Healthcare Provider Details
I. General information
NPI: 1316756927
Provider Name (Legal Business Name): YURHEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2025
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
162 JEKYLL ROAD
BAXLEY GA
31513
US
IV. Provider business mailing address
PO BOX 794
BAXLEY GA
31515-0794
US
V. Phone/Fax
- Phone: 478-401-0477
- Fax:
- Phone: 478-401-0477
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
ALTMAN
Title or Position: CEO
Credential:
Phone: 478-401-0477