Provider Demographics
NPI:1083072649
Name:APPLECARE LLC
Entity Type:Organization
Organization Name:APPLECARE LLC
Other - Org Name:APPLECARE IMMEDIATE CARE
Other - Org Type:Doing Business As
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 1:4795 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1115
Practice Address - Country:US
Practice Address - Phone:478-621-4447
Practice Address - Fax:478-621-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49081261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care