Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PROVIDENT HEALTH SERVICES, INC.
Active
Organization
PROVIDENT HEALTH SERVICES, INC.
Active
Other names
Memorial Health Hospitalists
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
4700 WATERS AVE, MEMORIAL HEALTH HOSPITALISTS, SAVANNAH, GA 31404-6220
(912) 350-2155
(912) 350-2156
Mailing address
4700 WATERS AVE, MEMORIAL HEALTH HOSPITALISTS, SAVANNAH, GA 31404-6220
(912) 350-2155
(912) 350-2156
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609293670A
—
GA
01
—
DA3772
RR MEDICARE
GA
01
—
DF7661
RR MEDICARE
SC
05
—
GPA921
—
SC
Enumeration date
12/13/2006
Last updated
06/04/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up