Provider Demographics
NPI:1407266331
Name:AVIDCARE MEDICAL
Entity Type:Organization
Organization Name:AVIDCARE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-660-9660
Mailing Address - Street 1:1333 WHITFIELD PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-8216
Mailing Address - Country:US
Mailing Address - Phone:912-660-9660
Mailing Address - Fax:888-501-4083
Practice Address - Street 1:415 EISENHOWER DR
Practice Address - Street 2:STE 1
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2600
Practice Address - Country:US
Practice Address - Phone:912-660-9660
Practice Address - Fax:888-401-5083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies