Provider Demographics
NPI:1669014304
Name:CONSTANT CARE OF VALDOSTA LLC
Entity Type:Organization
Organization Name:CONSTANT CARE OF VALDOSTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:BHUMIBEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:229-506-8089
Mailing Address - Street 1:207 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1859
Mailing Address - Country:US
Mailing Address - Phone:229-242-5050
Mailing Address - Fax:229-242-0716
Practice Address - Street 1:207 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1859
Practice Address - Country:US
Practice Address - Phone:229-242-5050
Practice Address - Fax:229-242-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty