Provider Demographics
NPI:1871991844
Name:CITY OF ABBEVILLE
Entity type:Organization
Organization Name:CITY OF ABBEVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-467-3201
Mailing Address - Street 1:215 DEPOT ST S
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31001-4363
Mailing Address - Country:US
Mailing Address - Phone:229-467-3201
Mailing Address - Fax:
Practice Address - Street 1:417 BROAD ST S
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31001-4305
Practice Address - Country:US
Practice Address - Phone:229-467-3209
Practice Address - Fax:229-367-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care