Provider Demographics
NPI:1093135568
Name:VOLUNTEER BOARD OF UHCS RESOURCES LLC
Entity Type:Organization
Organization Name:VOLUNTEER BOARD OF UHCS RESOURCES LLC
Other - Org Name:MAGNOLIAS BREAST HEALTH BOUTIQUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, VOLUNTEER SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:THOMPSON
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-774-2208
Mailing Address - Street 1:1350 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2612
Mailing Address - Country:US
Mailing Address - Phone:706-774-4155
Mailing Address - Fax:
Practice Address - Street 1:818 SAINT SEBASTIAN WAY STE 205
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2652
Practice Address - Country:US
Practice Address - Phone:706-774-4155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOLUNTEER BOARD OF UNIVERSITY HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies