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General NPI Number Information
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NPI Number | 1871208629
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Entity Type | Organization
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Legal Business Name | RMX BRUNSWICK, LLC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 664 SCRANTON RD STE 107
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City | BRUNSWICK
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State | GA
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Zip | 31520-1946
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Country | US
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Telephone | 912-208-5555
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Fax | 912-208-5557
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Provider Business Mailing Address
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Address Line | 24 GLENDALE AVE STE E
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City | BAXLEY
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State | GA
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Zip | 31513-0245
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDALL CRAWFORD
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Credential | APRN
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Telephone | 912-590-2184
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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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