Provider Demographics
NPI:1710222997
Name:MEDEX INPATIENT SERVICES, LLC
Entity Type:Organization
Organization Name:MEDEX INPATIENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-691-5070
Mailing Address - Street 1:811 13TH ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2700
Mailing Address - Country:US
Mailing Address - Phone:706-434-1590
Mailing Address - Fax:
Practice Address - Street 1:811 13TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2700
Practice Address - Country:US
Practice Address - Phone:706-434-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty