Provider Demographics
NPI:1821374364
Name:ANEW MEDICAL SERVICES GROUP, LLC
Entity Type:Organization
Organization Name:ANEW MEDICAL SERVICES GROUP, LLC
Other - Org Name:ANEW SERVICES GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:ANTIONE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-729-7229
Mailing Address - Street 1:102 LAKESHORE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3874
Mailing Address - Country:US
Mailing Address - Phone:912-729-7229
Mailing Address - Fax:912-525-3190
Practice Address - Street 1:102 LAKESHORE DR
Practice Address - Street 2:SUITE C
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3874
Practice Address - Country:US
Practice Address - Phone:912-729-7229
Practice Address - Fax:912-525-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care