Provider Demographics
NPI:1275773616
Name:S.I.P.S., INC.
Entity Type:Organization
Organization Name:S.I.P.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:DOUGLASS
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:706-447-3972
Mailing Address - Street 1:4264 WATERSTON COURTYARD
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5036
Mailing Address - Country:US
Mailing Address - Phone:706-447-3972
Mailing Address - Fax:706-447-3975
Practice Address - Street 1:2917-B PROFESSIONAL PARKWAY
Practice Address - Street 2:SUITE B
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3581
Practice Address - Country:US
Practice Address - Phone:706-447-3972
Practice Address - Fax:706-447-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163W00000X, 164W00000X, 376J00000X, 376K00000X
GARN165844163WM0705X, 251J00000X
SC29393163WM0705X
GA121-R-0351253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Multi-Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA121-R-0351OtherDHR, STATE LICENSE, NURSING SERVICES, PERSONAL CARE, COMPANION/SITTERS