Basic Information
| Provider Information | |||||||||
| NPI: | 1487319380 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | APPLECARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 MALL BLVD STE 202E | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314064834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123494945 | ||||||||
| FaxNumber: | 9123494105 | ||||||||
| Practice Location | |||||||||
| Address1: | 1430 US HIGHWAY 82 W STE 105 | ||||||||
| Address2: | |||||||||
| City: | TIFTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317938010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293880266 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2021 | ||||||||
| LastUpdateDate: | 11/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | NASH | ||||||||
| AuthorizedOfficialFirstName: | HEIDI | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 9123494945 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.