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Organization

MEDFUND LLC

Active
Other names
Horizon Augusta LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization

Contact information

Practice address
2803 WRIGHTSBORO RD, STE 18, AUGUSTA, GA 30909-3917
(706) 729-9800
(706) 729-8980
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52070692
BCBS PROVIDER #
01
7487068
AETNA PROVIDER #
GA
05
SL0069
SC
Enumeration date
05/23/2005
Last updated
08/22/2020
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