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General NPI Number Information
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NPI Number | 1043983646
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Entity Type | Organization
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Legal Business Name | HOUSECALLS OF AUGUSTA CORP
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 3540 WHEELER RD STE 201
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City | AUGUSTA
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State | GA
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Zip | 30909-1878
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Country | US
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Telephone | 706-254-5490
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 WHEELER RD STE 201
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City | AUGUSTA
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State | GA
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Zip | 30909-1878
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Country | US
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Telephone | 706-254-5490
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MEGAN BRADLEY MENDEZ
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Credential |
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Telephone | 706-254-5490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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