EXPAND HEALTH LLC NPI 1205556594

NPI Information

  • NPI: 1205556594
  • Provider Name: EXPAND HEALTH, LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 11D2267904
  • Address: 3441 CYPRESS MILL RD STE 101
    BRUNSWICK, GA
    ZIP 31520
  • Phone: (912) 419-5148

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NPI Details

EXPAND HEALTH, LLC is a primary care clinic center in Brunswick, GA. EXPAND HEALTH, LLC NPI is 1205556594. The provider is registered as an organization entity type.

The provider's business location address is:

3441 CYPRESS MILL RD STE 101
BRUNSWICK, GA
ZIP 31520-879
Phone: (912) 419-5148

The provider's authorized official is Tyler Cole .
The authorized official title is Ownder/provider and has the following contact phone number (912) 456-3502.

The CLIA number assigned to this NPI record is 11D2267904 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2022 and was last updated on 10/26/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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