Provider Demographics
NPI:1699529503
Name:SAPPHIRE COLLINS GROUP LLC
Entity type:Organization
Organization Name:SAPPHIRE COLLINS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:V
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:850-274-5963
Mailing Address - Street 1:1515 BOONE DR APT B6
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2699
Mailing Address - Country:US
Mailing Address - Phone:850-274-5963
Mailing Address - Fax:
Practice Address - Street 1:1515 BOONE DR APT B6
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2699
Practice Address - Country:US
Practice Address - Phone:850-274-5963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care