Healthcare Provider Details

I. General information

NPI: 1508694209
Provider Name (Legal Business Name): VICTORIA ANTHONY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W WASHINGTON AVE STE 134
HINESVILLE GA
31313-2544
US

IV. Provider business mailing address

100 BULL ST STE 200
SAVANNAH GA
31401-3378
US

V. Phone/Fax

Practice location:
  • Phone: 912-633-9080
  • Fax:
Mailing address:
  • Phone: 912-633-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: