Provider Demographics
NPI:1699178798
Name:GLYNCO MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:GLYNCO MEDICAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:912-223-9268
Mailing Address - Street 1:220 MEDINAH
Mailing Address - Street 2:
Mailing Address - City:SAINT SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2419
Mailing Address - Country:US
Mailing Address - Phone:912-223-9268
Mailing Address - Fax:
Practice Address - Street 1:220 MEDINAH
Practice Address - Street 2:
Practice Address - City:SAINT SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2419
Practice Address - Country:US
Practice Address - Phone:912-223-9268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049021261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty