Healthcare Provider Details

I. General information

NPI: 1992142152
Provider Name (Legal Business Name): APPLECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 N ASHLEY ST SUITE C
VALDOSTA GA
31602-5912
US

IV. Provider business mailing address

401 MALL BLVD SUITE 202E
SAVANNAH GA
31406-4862
US

V. Phone/Fax

Practice location:
  • Phone: 229-671-9100
  • Fax: 229-671-9101
Mailing address:
  • Phone: 912-349-4945
  • Fax: 912-349-4105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA JACKSON
Title or Position: PATIENT SERVICES MANAGER
Credential:
Phone: 912-349-4945