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General NPI Number Information
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NPI Number | 1659432326
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Entity Type | Organization
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Legal Business Name | BETTY SAXON ELDER CARE
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 1125 PINEY GROVE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-8714
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Country | US
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Telephone | 706-793-8242
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Fax | 706-793-2272
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Provider Business Mailing Address
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Address Line | 1125 PINEY GROVE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-8714
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Country | US
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Telephone | 706-793-8242
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Fax | 706-793-2272
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CYNTHIA DIANE CHRISTIE
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Credential |
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Telephone | 706-793-8242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 121-03-017-1
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License Number State | GA
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