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General NPI Number Information
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NPI Number | 1104141555
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Entity Type | Organization
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Legal Business Name | HARRISBURG FAMILY HEALTH CARE, INC.
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 423 CRAWFORD AVE
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City | AUGUSTA
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State | GA
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Zip | 30904-3641
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Country | US
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Telephone | 706-496-3885
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Fax | 706-496-3886
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Provider Business Mailing Address
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Address Line | 423 CRAWFORD AVE
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City | AUGUSTA
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State | GA
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Zip | 30904-3641
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Country | US
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Telephone | 706-496-3885
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Fax | 706-496-3886
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. WILLIAM M SHAFFER
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Credential |
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Telephone | 706-533-0983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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