Provider Demographics
NPI:1720559354
Name:GOLDEN YEARS GERIATRICS INC.
Entity Type:Organization
Organization Name:GOLDEN YEARS GERIATRICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-266-9132
Mailing Address - Street 1:PO BOX 1079
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-1079
Mailing Address - Country:US
Mailing Address - Phone:662-266-9132
Mailing Address - Fax:
Practice Address - Street 1:1233 COUNTY ROAD 108
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-9787
Practice Address - Country:US
Practice Address - Phone:662-266-9132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care