Provider Demographics
NPI:1356506026
Name:HOURLIFE LLC
Entity Type:Organization
Organization Name:HOURLIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-443-4243
Mailing Address - Street 1:2 MODENA RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-2121
Mailing Address - Country:US
Mailing Address - Phone:912-354-4687
Mailing Address - Fax:912-350-0606
Practice Address - Street 1:315 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2605
Practice Address - Country:US
Practice Address - Phone:912-443-4243
Practice Address - Fax:912-350-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DP5029OtherRAILROAD MEDICARE
511G700900Medicare PIN