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General NPI Number Information
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NPI Number | 1821437179
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC CENTER PC
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 210 E DERENNE AVE
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City | SAVANNAH
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State | GA
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Zip | 31405-6736
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Country | US
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Telephone | 912-644-5300
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Fax | 912-644-5283
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Provider Business Mailing Address
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Address Line | 4683 CHABOT DRIVE # 200
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City | PLEASANTON
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State | CA
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Zip | 94588
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Country | US
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Telephone | 925-621-2902
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Fax | 925-269-8423
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Authorized Official
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Title or Position | PHARMACY PROGRAM ADMINISTRATOR
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Name | DR. CHARLES HOPE
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Credential | M.D.
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Telephone | 912-644-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 043962
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License Number State | GA
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