Healthcare Provider Details
I. General information
NPI: 1306261540
Provider Name (Legal Business Name): AFFORDABLE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/25/2014
Last Update Date: 02/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
304 PARK ST
THOMASTON GA
30286-3741
US
IV. Provider business mailing address
304 PARK ST
THOMASTON GA
30286-3741
US
V. Phone/Fax
- Phone: 705-975-1089
- Fax: 706-647-0151
- Phone: 705-975-1089
- Fax: 706-647-0151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171WH0202X |
| Taxonomy | Home Modifications Contractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PETER
SMITH
Title or Position: OWNER
Credential:
Phone: 706-975-1089