# SHP PROVIDER NETWORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851288286
- **Authorized official:** MS. KELLY MOONEY (VP, MANAGED CARE)
- **Authorized official phone:** (229) 407-0213

## Contact information

- **Practice address:** 7505 WATERS AVE STE F9, SAVANNAH, GA 31406-3822
- **Practice address phone:** (912) 691-5711
- **Mailing address:** PO BOX 60969, SAVANNAH, GA 31420-0969
- **Mailing address phone:** (912) 691-5711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 282N00000X | General Acute Care Hospital | — | NULL | — |

## Other

- **Enumeration date:** 06/19/2025
- **Last updated:** 06/19/2025