Provider Demographics
NPI:1891154969
Name:BARE BONES MEDICAL LLC
Entity Type:Organization
Organization Name:BARE BONES MEDICAL LLC
Other - Org Name:ORTHONOW POOLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-484-3926
Mailing Address - Street 1:421 POOLER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-5102
Mailing Address - Country:US
Mailing Address - Phone:912-484-3926
Mailing Address - Fax:912-235-2550
Practice Address - Street 1:421 POOLER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-5102
Practice Address - Country:US
Practice Address - Phone:912-484-3926
Practice Address - Fax:912-235-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care