PEDS HEALTH NPI 1215483128

NPI Information

NPI: 1215483128
Provider Name: PEDS HEALTH

Doing Business As: ERICKA RUSSELL-PETTY

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 11D2059750

Address:
3710 WATERS AVE
SAVANNAH, GA
ZIP 31404
Phone: (921) 777-5490
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PEDS HEALTH is a health service clinic center in Savannah, GA. PEDS HEALTH NPI is 1215483128. The provider is registered as an organization entity type.
The provider Is Doing Business As Ericka Russell-petty.

The provider's business location address is:

3710 WATERS AVE
SAVANNAH, GA
ZIP 31404-209
Phone: (921) 777-5490
Fax: (912) 777-5491

The provider's authorized official is Ericka Russell-petty .
The authorized official title is Physiciann and has the following contact phone number (912) 777-5490.

The CLIA number assigned to this NPI record is 11D2059750 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/30/2016 and was last updated on 8/30/2016.

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
1	261QH0100X	Clinic/Center	Health Service	047258	GEORGIA	Yes

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: 5/5/2024

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