Provider Demographics
NPI:1366848715
Name:AAC ASSOCIATES
Entity Type:Organization
Organization Name:AAC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:FAATIMAH
Authorized Official - Middle Name:MALIKA
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-413-3947
Mailing Address - Street 1:1801 CHANDLER RD
Mailing Address - Street 2:APT 24
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-4968
Mailing Address - Country:US
Mailing Address - Phone:803-413-3947
Mailing Address - Fax:
Practice Address - Street 1:1801 CHANDLER RD
Practice Address - Street 2:APT 24
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-4968
Practice Address - Country:US
Practice Address - Phone:803-413-3947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002042314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========Medicare PIN