Southeast Retina Center Pc

LBN: Southeast Retina Center Pc
Southeast Retina Center Pc is an health care organization with primary practice located at 3685 Wheeler Rd Ste 201, Augusta GA 30909. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as the primary health care specialty. Southeast Retina Center Pc can be contacted via phone (706) 650-0061, or through Becker, Kevin via phone (706) 243-2259.

Contact Information

Primary practice address
3685 Wheeler Rd Ste 201 Augusta GA 30909
Phone: (706) 650-0061
Fax: (706) 650-0064
Website:
Map and Directions
Authorized official contact:
Name: Becker, Kevin
Phone: (706) 243-2259

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X

Profile Details

NPI number 1760467682
LBN Legal business name Southeast Retina Center Pc
DBA Doing business as
Authorized official Becker, Kevin
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2005
Last updated Jul 2nd, 2024 - about 2 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 1760467682 NPPES
Georgia MEDICAID 000605283B
Georgia MEDICAID 000293719A
Georgia MEDICAID GPA 668

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