Provider Demographics
NPI:1982025284
Name:BERMUDA GREENS HEALTH SERVICES
Entity Type:Organization
Organization Name:BERMUDA GREENS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-633-3208
Mailing Address - Street 1:370 MURRAY CROSSING BLVD NE
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-7593
Mailing Address - Country:US
Mailing Address - Phone:912-580-8748
Mailing Address - Fax:
Practice Address - Street 1:370 MURRAY CROSSING BLVD NE
Practice Address - Street 2:
Practice Address - City:LUDOWICI
Practice Address - State:GA
Practice Address - Zip Code:31316-7593
Practice Address - Country:US
Practice Address - Phone:912-580-8748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty