Provider Demographics
NPI:1427407618
Name:SALVAT INTERNAL MEDICINE, LLC
Entity Type:Organization
Organization Name:SALVAT INTERNAL MEDICINE, LLC
Other - Org Name:SALVAT INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-448-4050
Mailing Address - Street 1:PO BOX 4128
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-4128
Mailing Address - Country:US
Mailing Address - Phone:229-868-2112
Mailing Address - Fax:229-868-0001
Practice Address - Street 1:144 E OAK ST
Practice Address - Street 2:
Practice Address - City:MC RAE
Practice Address - State:GA
Practice Address - Zip Code:31055-4338
Practice Address - Country:US
Practice Address - Phone:229-868-2112
Practice Address - Fax:229-868-0001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DODGE COUNTY HOSPITAL AUTHORITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty