Hart-Moreland, Santrell Denise
Hart-Moreland, Santrell Denise is an sole proprietor health care provider with primary practice located at 158 Fairview Rd Suite B, Ellenwood GA 30294-2795. She recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Dietary & Nutritional Service Providers / Nutrition, Education. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Hart-Moreland, Santrell Denise can be contacted via phone (678) 289-5835.Contact Information
Primary practice address
158 Fairview Rd Suite B
Ellenwood GA 30294-2795
Phone: (678) 289-5835
Fax: (678) 289-5837
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 001761 | Georgia |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 001761 | Georgia |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 001761 | Georgia |
| Dietary & Nutritional Service Providers / Nutrition, Education | 133NN1002X | 1761 | Georgia |
Profile Details
| NPI number | 1376613968 |
|---|---|
| LBN Legal business name | Hart-Moreland, Santrell Denise |
| Credentials | O.D.,M.P.H. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 9th, 2006 |
| Last updated | Nov 16th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376613968 | NPPES |
| Georgia | MEDICAID | 00832818B | |
| Georgia | MEDICAID | 00832818C |
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