Shaw Living Pc

LBN: Shaw Living Pc
Shaw Living Pc is an health care organization with primary practice located at 2484 E Pinetree Blvd , Thomasville GA 31792-4854. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Shaw Living Pc can be contacted via phone (229) 226-8800, or through Bradford, Lacy via phone (229) 594-6800.

Contact Information

Primary practice address
2484 E Pinetree Blvd Thomasville GA 31792-4854
Phone: (229) 226-8800
Fax: (229) 226-8232
Website:
Map and Directions
Authorized official contact:
Name: Bradford, Lacy
Phone: (229) 594-6800

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1033778923
LBN Legal business name Shaw Living Pc
DBA Doing business as
Authorized official Bradford, Lacy
Entity Organization
Organization subpart 1 No
Enumeration date Jun 13th, 2019
Last updated Feb 28th, 2024 - about 9 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033778923 NPPES
Georgia MEDICAID 179012663G

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