Healthcare Provider Details

I. General information

NPI: 1841765633
Provider Name (Legal Business Name): ACUTE CARE EMERGENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 VETERANS PKWY
COLUMBUS GA
31909-1723
US

IV. Provider business mailing address

7901 VETERANS PKWY
COLUMBUS GA
31909-1723
US

V. Phone/Fax

Practice location:
  • Phone: 706-221-6800
  • Fax: 706-221-6921
Mailing address:
  • Phone: 706-221-6800
  • Fax: 706-221-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI JORDAN
Title or Position: CEO
Credential: PA
Phone: 706-221-6800