Organization
PRIMUS HARDING STREET
Active
Organization
PRIMUS HARDING STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BARANKO (CFO)
(229) 430-0416
Entity
Organization
Contact information
Practice address
503 S HARDING ST, ALBANY, GA 31701-2915
(229) 430-0416
Mailing address
1120 W BROAD AVE, ALBANY, GA 31707-4397
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
11/21/2011
Last updated
11/21/2011
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