Provider Demographics
NPI:1619353463
Name:A & J INDEPENDENT CONTRACTORS
Entity Type:Organization
Organization Name:A & J INDEPENDENT CONTRACTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:AILLIENE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:229-591-1032
Mailing Address - Street 1:306 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-4615
Mailing Address - Country:US
Mailing Address - Phone:229-591-1032
Mailing Address - Fax:
Practice Address - Street 1:306 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-4615
Practice Address - Country:US
Practice Address - Phone:229-591-1032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN181305251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management