Provider Demographics
NPI:1881837680
Name:LABOR AND INFORMATION SERVICES, INC.
Entity Type:Organization
Organization Name:LABOR AND INFORMATION SERVICES, INC.
Other - Org Name:FOOT SOLUTIONS OF AUGUSTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARION
Authorized Official - Middle Name:F
Authorized Official - Last Name:LABOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-228-3663
Mailing Address - Street 1:4219 WASHINGTON RD STE 1
Mailing Address - Street 2:MULLINS CROSSING
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4710
Mailing Address - Country:US
Mailing Address - Phone:706-228-3663
Mailing Address - Fax:706-228-3660
Practice Address - Street 1:4219 WASHINGTON RD STE 1
Practice Address - Street 2:MULLINS CROSSING
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-4710
Practice Address - Country:US
Practice Address - Phone:706-228-3663
Practice Address - Fax:706-228-3660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-09
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA20021026469335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6265540001Medicare NSC