| NPI | 1932399722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH A KIRBY President 912-629-2210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 040438) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: GA 040438) |
| 302R00000X Health Maintenance Organization (Licence: GA 040438) | |
| 305S00000X Point of Service (Licence: GA 040438) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2011-04-29 |