Provider Demographics
NPI:1477979425
Name:EFRIEDRICH SOUTHEAST GEORGIA
Entity Type:Organization
Organization Name:EFRIEDRICH SOUTHEAST GEORGIA
Other - Org Name:FIRSTLIGHT HOMECARE OF SOUTHEAST GEORGIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FRIEDRICH
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:912-275-7133
Mailing Address - Street 1:160 EH DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-275-7133
Mailing Address - Fax:
Practice Address - Street 1:160 EH DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-275-7133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care