Provider Demographics
NPI:1497712707
Name:LOWCOUNTRY NATURAL HEALTH CENTER, L.L.C.
Entity Type:Organization
Organization Name:LOWCOUNTRY NATURAL HEALTH CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ARD-KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:912-354-2222
Mailing Address - Street 1:1101 EAST FIFTY-FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404
Mailing Address - Country:US
Mailing Address - Phone:912-354-2222
Mailing Address - Fax:912-353-7431
Practice Address - Street 1:1101 EAST FIFTY-FIRST STREET
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-354-2222
Practice Address - Fax:912-353-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service