Provider Demographics
NPI:1992023824
Name:RALPH DONALD CORPORATION
Entity type:Organization
Organization Name:RALPH DONALD CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-815-7890
Mailing Address - Street 1:29 PLANTATION PARK DR
Mailing Address - Street 2:SUITE #704
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-9001
Mailing Address - Country:US
Mailing Address - Phone:843-815-7890
Mailing Address - Fax:843-815-7892
Practice Address - Street 1:29 PLANTATION PARK DR
Practice Address - Street 2:SUITE #704
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9001
Practice Address - Country:US
Practice Address - Phone:843-815-7890
Practice Address - Fax:843-815-7892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA999-R-0011253Z00000X
SCLIC-4-11-5465253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care