Provider Demographics
NPI:1316315781
Name:SAVANNAH MIDWIFERY LLC
Entity type:Organization
Organization Name:SAVANNAH MIDWIFERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CNM
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNM WHNP CPM APRN
Authorized Official - Phone:912-344-5066
Mailing Address - Street 1:1127 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-4045
Mailing Address - Country:US
Mailing Address - Phone:912-344-5067
Mailing Address - Fax:
Practice Address - Street 1:1127 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-4045
Practice Address - Country:US
Practice Address - Phone:912-344-5067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN161539261QB0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing