Organization
PULMONARY CARE OF CORDELE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT THEODORE HATCH CRT (MANAGER)
(904) 223-1602
Entity
Organization
Contact information
Practice address
14131 WAVERLY FALLS LN W, JACKSONVILLE, FL 32224-5858
(904) 223-1602
Mailing address
14131 WAVERLY FALLS LN W, JACKSONVILLE, FL 32224-5858
(904) 223-1602
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00252722
—
GA
Enumeration date
11/01/2006
Last updated
03/21/2008
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