Provider Demographics
NPI:1336257179
Name:APPLECARE LLC
Entity type:Organization
Organization Name:APPLECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-349-4945
Mailing Address - Street 1:401 MALL BLVD
Mailing Address - Street 2:SUITE 202E
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4862
Mailing Address - Country:US
Mailing Address - Phone:912-349-4945
Mailing Address - Fax:912-349-4105
Practice Address - Street 1:1111 GLYNCO PKWY
Practice Address - Street 2:BUILDING 1, SUITE 10
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-7921
Practice Address - Country:US
Practice Address - Phone:912-264-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6575OtherMEDICARE PTAN NUMBER