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General NPI Number Information
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NPI Number | 1710349972
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Entity Type | Organization
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Legal Business Name | FELLOWSHIP HEALTH CARE LLC.
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 6205 ABERCORN ST STE 101
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City | SAVANNAH
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State | GA
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Zip | 31405-5540
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Country | US
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Telephone | 912-335-1020
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Fax | 912-201-1752
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Provider Business Mailing Address
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Address Line | 6205 ABERCORN ST STE 101
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City | SAVANNAH
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State | GA
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Zip | 31405-5540
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Country | US
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Telephone | 912-335-1020
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Fax | 912-201-1752
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN HERTZWIG
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Credential |
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Telephone | 912-401-8730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 025R0794
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License Number State | GA
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