Organization
AUGUSTA PRIMARY CARE SERVICES LLC
Active
Parent organization
HOSPITAL CORP., LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOSPITAL CORP., LLC
Authorized official
ROBERT FAILE (VICE PRESIDENT)
(843) 856-7923
Entity
Organization
Contact information
Practice address
3624 J DEWEY GRAY CIR, SUITE 308, AUGUSTA, GA 30909-6584
(706) 855-5650
(706) 863-0821
Mailing address
3624 J DEWEY GRAY CIR, SUITE 308, AUGUSTA, GA 30909-6584
(706) 855-5650
(706) 863-0821
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298706473A
—
GA
05
—
298706473B
—
GA
05
—
GP5358
—
SC
Enumeration date
07/16/2008
Last updated
10/17/2017
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