Provider Demographics
NPI:1073696175
Name:TIM'S HOME MEDICAL OF BRUNSWICK, INC
Entity Type:Organization
Organization Name:TIM'S HOME MEDICAL OF BRUNSWICK, INC
Other - Org Name:GOLDEN ISLES HOME CARE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-261-4900
Mailing Address - Street 1:650 SCRANTON RD
Mailing Address - Street 2:STE F
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-1927
Mailing Address - Country:US
Mailing Address - Phone:912-261-4900
Mailing Address - Fax:912-261-1127
Practice Address - Street 1:650 SCRANTON RD
Practice Address - Street 2:STE F
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-1927
Practice Address - Country:US
Practice Address - Phone:912-261-4900
Practice Address - Fax:912-261-1127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52999939OtherBLUE CROSS/BLUE SHIELD
GA5692090001Medicare NSC