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General NPI Number Information
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NPI Number | 1548140635
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Entity Type | Organization
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Legal Business Name | GLAM STREAM LLC
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 514 MCARTHUR BLVD
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City | WARNER ROBINS
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State | GA
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Zip | 31093-3220
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Country | US
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Telephone | 478-550-6475
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Fax | 719-283-7966
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Provider Business Mailing Address
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Address Line | 514 MCARTHUR BLVD
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City | WARNER ROBINS
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State | GA
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Zip | 31093-3220
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Country | US
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Telephone | 478-550-6475
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Fax | 719-283-7966
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Authorized Official
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Title or Position | OWNER
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Name | CORA CAMPBELL
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Credential |
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Telephone | 478-550-6475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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